Attachment to Therapist: A Primer

This very long post is intended to replace the previous one on transference disasters and give patients and therapists a sense of how attachment to one’s therapist can come about and what to expect. It is also intended to clarify what is required of the therapist and what can go wrong. I hope this might embolden patients to have confidence in their instincts and rights and to initiate discussion of these issue as early in treatment as possible. (Photo: Allison Day, Flickr, CC BY-ND 2.0.)

On Attachment to Your Therapist

Jeffery Smith MD

What I have Learned

Eight years ago, a reader wrote, “I have a very strong attachment to my therapist and have come to see him as a father. I struggle with this on a constant basis, because he’s not my father, he is my therapist and is one hell of an ethical one at that and would never ever stretch the boundaries (which of course are some of the things that I wish for…).” I responded with a post and since that time, hundreds of reader comments and many more posts have created a trove of collective experience and a place for discussion of the best and worst that can happen in intensive therapy. I am writing now, to summarize what I have learned in the hope that it may help patients and therapists be successful in their work together. Of course the ideas here may not apply to all situations and are not a substitute for working with a credentialed therapist. These pages are made to be shared with therapists and to be of use to patients/clients in getting an overview of what to expect and what problems may be encountered.

Causes of Intense Attachment to One’s Therapist

As best I can tell, these feelings are the result of experiencing a shortfall of “primal love,” that is, early, attuned, empathic attention from the primary caregiver. For different people it has different meanings, but it tends to be in the realm of the 24/7, total, unwavering devotion for which very young children experience an intense and very real need. The child has no doubt that the only possible solution to a shortfall is to get the grown up to take away the pain by fulfilling that need. This kind of loving connection is experienced as a life-and-death need, and when not met (or perceived as lacking), leaves a sense of something missing that must, somehow be fulfilled. If not that, then the child undertakes to satisfy the need with his or her own substitutes. This yearning can remain smoldering outside of consciousness for a lifetime. Therapy is like water to a dry seed. The yearning comes alive in the context of a relationship with someone who seems to understand and be willing to help.

Values as Defenses against Chronic Pain and Anger

When children carry distressing neediness day in and day out, in order to manage the constant pain, their mind eventually develops a value system that functions to suppress the constant ache. This system discourages conscious neediness by adopting an internal prohibition against it. “You shouldn’t need attention.” This is effective in pushing the yearning out of awareness, but further fuels its intensity. Another normal reaction is anger. Children can be thought of as consumers of parenting services. They know what is right and what isn’t, even if they don’t dare think it. So it is normal for children who have experienced neglect of some kind to feel anger. This too is a distressing emotion to carry, and can also be experienced as dangerous. By the same mechanism as the prohibition against neediness, the child also develops a value system prohibiting anger. “You shouldn’t be angry.” That only intensifies the anger, so we end up with a third set of internalized attitudes or values: “It’s your fault. You are no good.” Then the anger has somewhere to go and a pathway for it to be acted upon. It is not uncommon for a person who has experienced neglect to have a history of both overt anger (when it overflows) and anger turned against the self. Having these three types of values standing against one’s natural feelings and longings intensifies them greatly and leads to huge amounts of shame. Along with the unfulfilled needs, themselves, these internal defenses form significant part of the difficulty patients bring to therapy.

“Acting Out” to Soothe Emotions

This unconscious combination of unmet needs, angry feelings and the values that hold them in check, leads to a number of strategies for substituting for needs and soothing the distress. They may not fully blossom till the teens, when their power is discovered. Food, cutting, bulimia, all kinds of sexual acting out, drugs, gambling, are among the symptoms, as well as repeated, unsatisfying attempts to find comfort in relationships. These often combine soothing with self-punishment, which decompresses some of the rage. However, acting out is never more than a band-aid and must be repeated often to provide any kind of relief. The painful consequences of acting out only increase the anger, and with it, pressure to repeat the same maladaptive coping strategies.

An important principle of therapy is that acting out undermines the benefits of therapy. As the patient focuses on the consequences of self-defeating patterns, little energy is left to deal with what underlies them. Furthermore, the acting out takes energy away from the therapy, where there is a chance of actually working out the anger, and neediness that fuel the whole edifice. The mind tends to see this as too dangerous. After all, the therapist might be another source of disappointment and ultimate despair. So there is a strong tendency to favor acting out, even though it is guaranteed not to work.

Attachment to a therapist is one of the healthiest things that can happen to a person caught in such a tangle of feelings. It means there is hope of a real solution, hope that there is a way to have life as it should be. Therapy is all about channeling this healthy desire away from the old patterns and towards hope of healing and a better life. That said, we still need to recognize that the mind will naturally try to direct the therapy in the direction of repetition of the old patterns instead of examining and understanding them.

When attachment to a therapist is sexualized, I usually think that the drive comes from the yearnings and emotions described above, but that premature exposure to sexuality, in some form, has most likely occurred, leading to expression in sexualized form. This can be challenging because it also engages mammalian biology in a powerful way, adding to the drive to find fulfillment of unmet needs.

Transference

When patients/clients come to therapy, the child in them wakes up. Traditionally, this is called transference, meaning that the person reacts as if the therapist were a figure from the past. Unfortunately, this term is far too dry and technical to even hint at the real life experience, both for patient/client and for the therapist. (please let me call you patients, as that is what is most natural to me, and in no way disrespectful) To put it simply, transference just feels like life. Patients feel upset when the therapist seems not to care. Therapists feel the patient’s loving attachment or criticism in the here-and-now. These feelings do not come with an asterisk saying that they are not really about the present.

Why is this? Emotional interactions in therapy are the domain of our mammalian, emotional brain, which operates automatically outside of consciousness and has been designed through evolution to take care of needs and keep us from danger—as our non-conscious mind understands it. So in the therapy room, we have not just the conscious adult patient, but, for all practical purposes, a young person as well, with a different way of seeing the situation and different ideas about how to make things better.

Children solve problems differently from grown ups. Their solution to any serious problem is to motivate the big person to solve the problem, meaning to take away the pain. Adults have a different approach. It is to analyze the problem and personally to take required steps to solve it in whatever way will work best. In the case of early life deprivation, the childlike solution is for the therapist to take away the pain by giving the love that was missing. On the other hand the adult therapeutic solution is to grieve what never will be and make peace with reality. This is obviously, not the answer a child would think of or accept.

Transference refers to times in therapy when the patient’s words and actions reflect the child’s perceptions and methods for solving problems. Usually this is (unconsciously) filtered to make it seem reasonable. For example, the patient might think, “I just want help feeling better.” The feelings surrounding that thought would be more consistent with, “I want you to take away my pain.” Hopefully later, the patient might feel safer and more comfortable and might admit that “I want you to hold me and be there all the time.” That would be a more accurate rendition of the inner child’s true wish. I hope it is apparent that characterizing this a distorted perception is far too limited. The young version is actually an alternative and age appropriate way of understanding life and solving problems. Because this isn’t just perception, but embodies goal directed behavior, I have personally, abandoned the term, transference, and simply think of an “inner child” with his or her own agenda. It is far more accurate to picture a being who seeks to feel better through methods that are appropriate for a young person. This is so much more true to life than thinking of transference as an adult with errors in perception. In addition, thinking in terms of an inner child encourages compassion and understanding rather than judgment.

What patients react to is their perception of the therapist’s inner motivation and intentions. They observe words and actions, but their emotional reactions are to what they imagine to be the therapist’s motivations. In fact, knowing other people’s true motivation and intentions is difficult at best and extremely subject to error. Husbands and wives do it all the time, mistaking the other’s intentions. “You only said that because…” We look at actions and say, “the only reason he/she could have done that is…” That proves it! There is no other possible explanation. Actually there are other explanations, but, under the pressure of emotions, the range of possibilities seems to narrow. Patients develop an unshakable rationale for their interpretation making it very difficult to show them that transference conclusions are in error. Their conclusion feels right, makes complete sense to them, and there is “no other possible explanation.” Furthermore the therapist’s defense is only an additional proof that he/she is trying to cover up bad intentions. So, helping patients understand the child in the room is really challenging, even for therapists skilled enough to see it themselves.

The biggest source of trouble in therapy is the therapist’s failure to recognize or correctly deal with the presence of the child. It is when the therapist reacts as if the patient were a difficult adult. This misinterpretation is the therapist’s responsibility because the patient doesn’t have a fair chance of recognizing what is happening and can only be expected to experience transference as simple reality. It is also hard for shame-ridden patients to admit to having an inner child. Transference can feel like ordinary reality to therapists, too, so those who treat these patients need a lot of knowledge, training, and experience to handle the interaction as it really is, the result of what appears to be an adult with an active, but not obvious, child in control of much of the surface behavior.

Countertransference Problems

In the comments on this blog, there are far too many painful accounts of disastrous errors by therapists. I will try to discuss them here, both for patients’ awareness and for therapists.

Brand of therapy: There are many types of therapy and not all of them recognize the existence of transference or include the concept in their vision of how therapy should be conducted. In these types of therapy, the therapist is usually seen more as a technician, brought in to correct errors of behavior or cognition. Some theoretical explanations discount the person of the therapist, creating an unnatural persona which can be used as a shield to hide behind. With such an approach emotional reactions to the therapist are not considered relevant to the transaction at hand, and, like personal issues in the workplace, should be kept out. If they intrude, it is the patient’s job to eliminate the distraction and get on with the work. Better clinicians in all types of therapy recognize that this is not a proper way to approach patients, but a number of the disasters reported in these pages show that such concepts of therapy do exist, and are not compatible with the kind of therapeutic work discussed here.Another problematic brand of therapy is the kind where the therapist is not supposed to show his or her emotions. This goes back to a 19th century ideal that the scientist was objective and had no effect on what he was observing. Hard science has abandoned that position, but some therapists still cling to it. It is not possible to avoid communicating one’s emotions. Modern Freudians have left this attitude behind, recognizing that affective interaction is part of what makes therapy work. On the other hand, there remain therapists who have been taught or believe that sharing their feelings is off limits. For patients whose problems stem from unmet needs, this is extremely depriving, and will tend to generate intense reactions simply to the repeated deprivation. It is not impossible that this deprivation might lead to doing the work of grieving for absent love and suport, but more likely, the child will simply go underground and wait for another time and place for needs to be met.An additional problem comes up in therapies that discourage disclosure of therapist feelings. The patients we are talking about are extremely sensitive to what is going on with the other person. Their lives have depended on it. When, as has been chronicled in this blog, they detect a reaction on the part of the therapist, at worst, they silently draw conclusions. At best, they bring up what they noticed and ask for help coming to a better understanding. A therapist who systematically refuses to clarify the truth leaves the patient hanging, forced to assume that their worst fears are correct. Another way to express this is that breaks in the relationship are inevitable and need to be repaired before the work can proceed. A therapist who is too vulnerable to tell the truth or has been trained not to, will be limited in his or her ability to repair breaks in the positive therapeutic alliance. A great deal of research in every school of therapy tells us that maintaining a healthy alliance correlates with a successful outcome.

Institutional Problems: A number of accounts describe supervisors or clinics where either people or policies are not able to accept intense feelings on the part of the patient. When the therapist reports what is going on, there have been sudden discharges and legalistic blaming and rejection of patients. This, of course, leaves the patient devastated, wounded, and with no place to seek support in healing.

The Therapist’s Inner Child: Traditionally this is called countertransference, but I would rather say that therapists have inner children like everyone else. Hopefully the therapist’s inner child’s needs are taken care of outside of therapy and there is harmony between the therapist’s child and grown up selves. This highlights what should be obvious, that therapists doing intensive therapy need to have had successful therapy, themselves. It is not even worth speculating that your therapist might have grown up so healthy as never to have been at odds with his or her inner child.

Limited Experience: It is a great help to have a seasoned therapist who has experienced his/her own inner child and patients’ inner children before and is comfortable handling whatever might happen. Anxiety and uncertainty on the part of the therapist fuels anxiety in the patient. When sexuality is an issue, an older therapist or one of a non-problematic gender can make the work easier.

Therapist Handling of Errors: None of us is perfect. In spite of our best intentions, we “miss the boat,” our inner children act up, we have preoccupying things going on in our lives, we get sick, we have changes in our circumstances, we underestimate our stamina or generosity. When these things intrude, they may be forgivable and it may be possible to heal the break in the relationship and the impact on the patient. What is required? Honesty. Too much disclosure may distract and make it “about the therapist,” but at least an acknowledgment allows the patient to avoid the pitfall of self-blame. The therapist’s willingness to acknowledge what happened and to feel the pain and distress it caused to the patient is the least we can do to allow healing from the consequences of our inevitable shortcomings and failures.

Preventing Disasters

This is really challenging for patients, and a troubling problem for the field. So far I don’t know of an effective means of prevention. Licensing and credentialing may help keep the situation from being even worse, but in the pages of the blog, you will see that much remains to be desired. In some cases, it is hoped that sharing this document with a therapist might create a basis for dialog and clarification of therapist beliefs, qualifications, and experience.

Here are my thoughts about what patients can do: You may have been taught to ignore your instincts and override your sense that something is not right. You may have been taught to feel ashamed of your needs and wishes. But as a therapy patient it is important to respect your instincts and listen to your insides. It can be critical to take the risk of asking difficult questions and questioning things that don’t feel right. A therapist should take your concerns seriously and be open to how it appears and feels from your point of view. Therapists are used to being the one who knows, and may not really be open to questioning themselves. Answers that don’t satisfy should be suspect. Ask about the therapist’s understanding of transference and how it should be treated as a therapeutic opportunity. Ask about the supervisor and the clinic and their policies. Dare to talk about your feelings as early as you can. It is far better to cope with a treatment failure earlier than later. As I have often suggested in the blog, if you can’t talk about your feelings directly, then talk, instead, about your difficulty discussing your feelings. At the end of this primer, I’ll make another suggestion about what to do if something doesn’t feel right or if you are not making progress.

Boundaries

Boundaries are protective in that they tell the inner child what can and can’t happen. When they are maintained consistently, this allows the child to relax and not have to keep testing over and over. If the testing must continue, it is not as intense and distracting. Boundaries lower the level of uncertainty but don’t take away the child’s drive to have the therapist fulfill his or her needs. The child’s wishes will not and should not disappear but will be channeled by boundaries towards doing the unfinished emotional work of grieving, acceptance, and finding more satisfying ways to approach life.

Boundaries also help the therapist. Therapists need alone time, time with other patients, time to recharge their batteries. They need some privacy in order to keep their needs met. The boundaries they set are not only to protect the patient, but to protect the relationship and the work by shielding the therapist as a person.

Boundaries need to feel reliable and predictable, but sometimes things happen. Unforeseen events and spontaneous reactions can give a glimpse of the therapist as a real person. So, on occasion, can a “failure” such as the therapist getting upset with the patient. These events may be, but are not always bad. They can cause a break in the alliance, but they can also cement it by showing the therapist as human. They do need to be talked about openly, and that is the therapist’s responsibility.

Good boundaries are also what protects the patient from being used to fulfill therapist needs. Doing therapy is often a satisfying profession, but therapist needs should never override what is best for the patient’s healing process. Sharing too much information about the therapist’s life is a minor example. The seriousness goes up from there.

One less obvious kind of therapist need is a therapist’s need to be helpful and loved. Patients may yearn for “tokens” of love, tangible, but ineffective substitutes for the understanding and compassion that are the gold standard of what therapists have to give. Extra time, giving in to patient’s wishes, and making promises never to leave are examples of therapist actions that encourage expectations beyond what the therapist may ultimately be able to handle or fulfill. The result can be painful disappointment and a another hurtful break in the relationship.

Finally, patients’ inner children often want “just one little thing” from the therapist. Maybe a hug or a bit of time outside the session. These are tests, but there are two kinds, and it is not easy to tell the difference. One test is to see if the therapist’s boundaries are reliable. If the therapist bends his or her boundaries to accommodate, then the child concludes that the therapist can be coaxed into taking away the pain. From then on, all effort is put into getting the therapist to give more and to bend the boundary further. This kind of boundary failure is very hard to come back from.

On the other hand, there have been reported a number of instances where the test was to understand if the therapist is really human. Once in a while, showing a willingness to be flexible about a boundary is just what has been missing to help the inner child really know that the therapist is a human being who cares. How can you know the difference? The only guideline I can be clear about is that the more innocuous the boundary bending, the less dangerous. Otherwise, unfortunately, the outcome can either be very positive or quite dangerous. What I can say firmly is that the rationale, often used by therapists and patients, that the therapist is fulfilling some childhood need, and that once fulfilled, the need will be taken care of, is not true. This is a comforting illusion, but facing and working with the painful feelings is the only thing that will actually put them to bed.

Healing the Needs

As implied in what has already been said, there are two basic healing processes involved in successful therapy. The first, in a nutshell, is for the child to accept that major aspects of the unmet needs of childhood will never be met, but that the pain of acceptance can heal, preferably in the context of an attuned and compassionate relationship. The second, and perhaps just as challenging form of healing, is learning to override those unfortunate values and prohibitions standing against healthy feelings of anger and neediness.

It isn’t possible in therapy or elsewhere, to ask a patient to give something up without something of value to replace it. The only way the child can accept the therapist’s accurate compassion as a substitute is by experiencing that the trade-off feels OK. In order to experience that feeling, the child has to accept deprivation of primal love and simultaneously experience positive compassion. How easy is that to engineer? Not!

Probably (because things don’t always occur in the order expected) the first thing will be to get over the anger. Otherwise, doing without a substitute for primal love feels like being punished. Punishment or purposeful deprivation supported by the therapist will generate anger, which will need to heal the same way a temper tantrum heals. That is, hopefully, you get held (metaphorically in therapy) and prevented from doing harm until the rage abates and tears start. Or if you are self-punishing (for having anger and neediness) you have to give that up. Only then, without the distractions of rage and destructiveness or self-condemnation, can the patient experience having a need, not having it fulfilled, and being understood with compassion. When those conditions are fulfilled, healing takes place.

Not so fast. When rage and destructiveness are taken care of, there is still the barrier of shame about expressing or even having needs. As long as needs are not shared, they stay underground and acceptance can’t happen. So the therapy may have to overcome a lot of shame to allow needs to be felt and expressed out in the open. Then it is possible for the adult patient and therapist to help the child patient understand that some needs can’t be met, and to do so in a context of accurate empathy and compassion. With that, the two necessary conditions are met and healing happens.

Bottom line: Goal 1. Terminate destructive acting out. Goal 2. Recognize and manage need fulfillment by substitutes that prevents facing the pain of unfulfilled needs. Goal 3. Allow anger and/or shame and neediness to the surface and work with them. Goal 4. Find acceptance of therapist’s understanding and compassion as next best to having unmet needs fulfilled.

Healing Unhealthy Values or Prohibitions

Here I am talking about the prohibitions against anger and neediness. These values are internalized as part of the conscience. When we fail to fulfill the dictates of our conscience we feel shame or guilt. Shame is a sure sign that there are values involved. Usually these values are reflections of how the child experienced the attitudes of the primary caregiver. I won’t explain why here, but these values are internalized in a way that is permanent. For example, we never lose our shame about failures of toilet training. So the best we can do is actively to override unhealthy values. That means recognizing that they are dysfunctional and telling ourselves that it is OK to have needs and to feel anger. More important, it means acting as if it is OK to have those feelings. This is because acting according to unhealthy values reinforces them. Acting the opposite is quite hard to do, and needs to be kept up indefinitely. It takes work and active behavior to repudiate unhealthy values, but this can and must be done to free oneself from this aspect of the legacy of deprivation.

Moving On from Therapy and the Therapist

There has been a lot of discussion in the blog about the end of the therapy relationship. Traditionally therapists thought that “termination” had to be a final cut-off in order to reap the benefits of full independence. I think a more nuanced version is as effective and more humane.

Just as I think the inner child concept is the most accurate way of understanding transference, I believe that parents and children give us the best way to understand how therapy comes to an end. When children leave parents under healthy conditions, they don’t need to end the relationship. On the other hand, over-involvement with parents can interfere with the transition to adult life. The same principles hold with regard to therapy. Difficulty letting go is a problem to be dealt with specifically, rather than by a general mandate of complete separation. Personally, I see no advantage to closing the door. When former patients contact me I am always glad to hear from them.

Hopefully as therapy goes on, the patient will be finding more healthy fulfillment in positive adult relationships and activities. If this is not happening at an appropriate pace, then one should wonder if something is getting in the way. In my experience, patients often have a kind of loyalty to their family of origin and to the past. Completely outside of consciousness, they may hold onto wishes or yearnings for support from those who should have given it in the first place, but never will. Perhaps this is because of a stubborn (as children’s wishes are) tenacity about repairing childhood rather than moving on, or it may be due to a reluctance to let the original caregivers “off the hook.” The therapist may serve as a safe person half-way between family and the outside world. As the patient takes risks and gains confidence, relying on the therapist should naturally lessen.

When fulfillment of age appropriate needs is steadily being transferred to the outside world, the patient will increasingly find outsiders more interesting and rewarding, and the beloved therapist, a bit boring. Then it is time to move towards reducing or ending regular sessions. Sometimes it takes discussion of the idea of ending to bring out feelings like anxiety and loss, that need to be processed. Letting go is a big event, and needs to be respected like any other leave-taking. But the processing of emotions is something that, by that time, patient and therapist should have long since learned to do together.

When moving on seems impossible

In general I interpret these feelings as indications that the healing journey consisting of trading the childlike solution for the adult solution of grieving and acceptance has somehow been blocked and not completed. If that is the case, then the question for patient and therapist is how, exactly, has the inner child been able to avoid facing the dreaded pain of not having fulfillment. That is an excellent question for patient and therapist to tackle.

Earlier I promised a powerful source of help in case things get bogged down. When there is an impasse, let me recommend the technique of consultation for both therapist and patient. Bringing an experienced, but neutral third party into the conversation can often break up a logjam. Usually the answer is obvious to the consultant: Transference has been missed or, to say it in my terms, the inner child has not been recognized or given needed help. Having someone with a firm grip on the process is very reassuring for everyone and should be done more often than it is.

For More Information

I would refer everyone to the rich pages of the blog as well as to the several books I have published that cover many of these subjects. They are highlighted in the Bookstore area of the blog. To therapists in particular, let me say that I am an integrative therapist and not aligned to any one school. My way of looking at pathology and the processes of therapy is embodied in the Affect Avoidance Model, on which my professional textbook, Psychotherapy: A Practical Guide (Springer 2017) is based.

93 Comments

Your work is genius. I hope one day you become a trainer of therapist. I am sure many therapist get locked up and the key thrown away because they themselves didn’t know how to deal with a “pretty” girls inner child. When the truth is an inner child is dealing with another inner child. We are all human. Therapist NEED your wisdom and guidance. You have a gift. Your wisdom is second to none.

This is such a helpful and very clear explenation. Thank you SO MUCH.
I just started studying MSc in PersonCentred and Experiential Psychotherapy and recognised something what happened to me with my previous therapist and I am hopefully just starting to get over it with help of someone who is a lot more experienced.

Hello Jeffrey,
I have one comment and one question. My comment is in response to this: (please let me call you patients, as that is what is most natural to me, and in no way disrespectful). Your book and blogs have been very helpful to me and I will read what you write whether you call me a client or a patient, just as I read books and articles from an earlier time that refer to me, a woman, as “man” or “he.” But I would prefer to be called a client because that puts us on equal footing. If you call me a patient, in my perception it means that you see me as sick. That might feel ok if I had cancer but it does not feel good in the case of mental health. The word implies a power differential – I am the lesser, and you are the greater, because of special knowledge or training, a certain expertise that you claim. That seems to me to be a throwback to the paternalistic and holier-than-thou attitudes of a century ago. If I call a computer geek to come fix my computer problems, he does not call me his patient! That would feel awful. He’d be lording his special knowledge over me in my vulnerable, needing his help, situation. Humility calls for client, not patient, in my opinion. We’re all in this being human thing together. No one has all the answers. Client signifies a working relationship between equals, a provider and a consumer of services.

And that leads me to my question. Because of my upbringing, my relationships have followed a pattern – me taking care of the other person in return for them liking me. I’m becoming very aware of that pattern as a result of therapy, and some of my relationships are changing as a result. I’m not willing to put myself second. I’m not willing to be “understanding” if someone is treating me badly, “Oh he had a difficult childhood,” etc. Recently I called an old friend on his reluctance to pay me back some money that I lent him years ago, realizing that a “friend” would actually pay me back. I wonder if this relationship will last as I start standing up for myself. Ok, sounds healthy, right? But then I began to think about therapy and how very expensive it is (I don’t have insurance) and how the minute I stop paying, my therapist will no longer “be there for me.” She acts like a mother sometimes, she acts like a good friend sometimes, she behaves like a professional, I trust her boundaries. She acts like she cares about me, and I believe she does, but I know that the minute I stop paying her it will all end! So it feels exactly like all the other relationships where I sacrifice something in order to get someone’s love and attention. I will bring this up with her next week, but I wonder if you can offer any insight into my conundrum.

Hmmm, Sarah, Your point about client is well said, though I think by the content of what I write, our equality is clearly there. It feels strange for me to change a professional tradition that goes back quite a few centuries, and to do so after over 40 years of following that tradition. So for me, the word has evolved to a different, non-paternalistic meaning. I can see, though, how it rubs you the wrong way. I guess the issue relates to your other question about payment.

In truth, the relationship is equal but not symmetrical. A Geek Squader “takes care of” her clients, and they pay money for her time. Your therapist “takes care of you” by putting aside her emotional needs and attending to you alone for a period of time. What equalizes or balances the relationship is payment. That financial arrangement justifies (makes balanced) an unusual emotional relationship, not unlike that of mother and child, where one person doesn’t have to “take care of” the other. It is asymmetrical, and that is what makes it work. If therapists were to derive their emotional needs from their relations with clients, as friends do, then the relationship would be symmetrical, but you wouldn’t be able freely to say what you feel or think. You would need to be tactful or risk damaging the relationship. That is different from your lending money. There you are “taking care of” a need of your friend, and your friend would be expected to feel an obligation to “take care of” you back. The friend didn’t and left an imbalance. I hope that is clarifying. JS

Good answers. I have to let the second one sink in, see if it satisfies all the parts of me, but logical mind is satisfied. As for your first answer, I was thinking, but didn’t say, that the content your writing does indeed contain a very definite, comfortable, and encouraging feeling of equality. And a client really does have to be very “patient” with the process of therapy, so I’ll think of it that way. I’d like to hear more about how the word has “evolved to a different, non-paternalistic meaning for you.” Sometime, if you ever feel like writing about that. Thanks again.
Sarah

Having sat with your responses overnight, I find something still sticking in my craw. You wrote, about using the word patient instead of client, “It feels strange for me to change a professional tradition that goes back quite a few centuries, and to do so after over 40 years of following that tradition.”

But you had no trouble answering my question and using the pronoun “she” in referring to the Geek Squad person, even though most Geek Squaders are not hes, and even though the literary tradition of the generic he goes back quite a few centuries. You may have written papers in graduate school using only “he” for a pronoun – this change has come about in my lifetime, I’m guessing yours too. So what’s the difference? That’s a rhetorical question – I don’t need an answer. I’m just asking what your attachment to using a word that makes some people uncomfortable is really about. Maybe there’s more to it than what you’ve said.

Oh my gosh, I just realized what this is about for me! I don’t trust anyone. I can’t let a therapist be an expert. I don’t want to give them any power. I can’t allow myself to be a patient. I have a horror of the medical profession – I never go to doctors. I am too proud (ashamed, scared) to admit how much I do in fact want and need help. Ah, maybe now I can surrender to this process a bit more. 🙂

This is so beautifully and informatively written and with such compassion for both the therapist and the patient. It’s personally very helpful to me, and I imagine will be extraordinarily helpful to anyone who stumbles across it via google searches.

An important piece of goal #1 has been omitted. Acting out will cease when the child feels safe. The first goal must always be to build an environment/relationship of safety for the child part (Judith Herman). It is not necessary to focus on the acting out, but rather on the safety needs that underlie the behaviors. Creating safety leads to containment, the holding environment (Winnicott).

“The biggest source of trouble in therapy is the therapist’s failure to recognize or correctly deal with the presence of the child.”
“It is also hard for shame-ridden patients to admit to having an inner child.”

I was finally the one who brought up my attachmentv(in an email) to my therapist. He was okay with it– he said he understood it and we discussed it in person for a red hot minute. But that is it– we’ve never talked about it again. I’m completely full of shame on this one. I cannot bring it up again–right? Or is that the only way I will ever be able to let go, do you think?
Right now my thoughts are, I’m just gonna quit going and see if he even notices– which I know he probably will. But then my true “fear” is, that will be that and I’ll feel pain and he’ll feel little and that will just suck. He’ll move on and not contact me and I will know that although he cares he really didn’t care “enough”. All sounds pretty childish…

Dear TLC, I believe that acting as if your attachment is shameful has a way of confirming the foreign belief that it is not OK. Perhaps showing the post to your therapist could be a help in opening up the subject. It is very sad to decide to move on, leaving in place an attitude against oneself that came from neglect and should not be allowed. JS

So, a crummy dad who never really seemed to love or even like me, a crappy uncle who took advantage, and a mom not able to stand up for me- yup we’ve talked about it, and talked and talked. I’ve wept about it. It makes me understand the longing for a father figure and I know how not having one can screw up some. I understand better how all of that crap shaped me. But…I have been going to see him for nearly 3 years. I should be done–
I know you’ve probably answered this a million ways, but I am just trying to figure out again how discussing my feelings for him and my longing for him to be a part of my “real life”, is helpful.

Plus, whenever we end our sessions lately he says, “Call the office to make another appointment, if you want to.” I know I am so sensitive and he is probably just letting me know I am in control, but it bugs me. He seems to be cutting me loose– maybe. Of course he’ll never do it. I’ll have to be the one, but I think he thinks it is time and I’m too attached. So that’s why I’m thinking of stopping appointments– it’s totally a test. Mr. Therapist…do you really care???? But even just writing about quitting makes my stomach go flip,flop, glug.

I’ve noticed that inner children are quite action oriented. They tend to think that the answer is taking some dramatic action that will solve everything. Usually it ends up kicking the can down the road. A manipulation to get your therapist to indicate that he cares is not going to solve the problem because the next question is, does he REALLY care. What really makes the work go forward is both therapist and patient asking why it is so hard to accept the ample evidence that he he demonstrates “good enough caring.” Is it because of a belief that one has to be perfect for anyone really to care? Is it protection against the devastation of learning that someone important actually did not care? The real answer is more likely to be deep in those kinds of questions. JS

Interestingly enough, I have that “does he REALLY care” thought pattern a lot, in nearly every venue. For example, at work I’ll do something well and I will think my boss believes I am doing a really great job and I am really valuable to him, but then a day or two later I am sure he thinks I suck. At home I never really believe my husband really cares about me or wants me and if he was just a less honorable man he would have ditched me by now. There are other examples, but I’ll leave it at those. I’ve never thought about it like that before.

The perfection piece also rings true, but my therapist and I have explored that one. No matter how good I was, no matter what I achieved, no matter how well I did in school or in sports I pretty much went unnoticed at home– particularly by my dad. I kept thinking my next accomplishment would be the key, but it never was– not when I would be the best on the team, not when I graduated with honors from college, not when I got married, not when I got pregnant with my first child. Nothing… and then he up and died and all my chances to prove myself were gone.

I wish I could address my neediness for my therapist’s attention with my therapist. I wish I had guts to bring it up– or better yet I really wish he could be the one to bring it up. I guess if neither of us does nothing will get solved and I will stay stuck. Then again, if I stay stuck I won’t have to say good-bye.
Just kidding–sorta.
One thing that does make sense is when I start to think of this inner child as being a separate being from me. I don’t like this inner child so very much. She makes me quite embarrassed by her neediness and her craving for attention and her uncertainty about her looks and her abilities and… the list goes on. When you wrote about my inner child in the third person saying “inner children are quite often action driven” that style of writing kind of helped me look at this child from a more neutral position instead of always judgmental one. I hope that is healthy and a good idea.

It just feels like I have been mulling this over and over and over and talking about it over and over and over with my therapist and although I have grown in three years time, I am also ready to not need my therapist or at least not have that constant desire for him to be my dad. I just wish I had met him in a different capacity, like as a neighbor or family friend– then I could always have him in my life. I’ve just never really felt like I have ever had an adult male figure in my life that really cared or felt a need to protect me. Sometimes I think that if I just knew my sessions with my therapist weren’t SUPPOSED to end, then I could just relax and go with it. I keep trying and failing a bit.

Ok, this has just sank in…tears in my eyes…thank You Jeffery. You know its just that you never know when a small comment of yours becomes an important building brick or small corner stone on someone’s road in life. This comment was one. Thank You for doing this! I know it must take up a lot of your precious time, but please keep it up!

“I’ve noticed that inner children are quite action oriented. They tend to think that the answer is taking some dramatic action that will solve everything. ”

It seems to me that a big part of the healing if for the child to be allowed to FEEL. Getting a warm space where the neediness, the sadness, the anger are acknowledged with compassion and care, authentically enough, for the child to allow these very painful feelings to come up, be embraced.

and the best way for that is to NOT act, because we need to really FEEL, things that are difficult to feel, buried, repressed, clumsy, shaming feelings,

Speed or rushing to act or talk is then just the expression of nervousness, fear, and aggressive denial of oneself.

Let the feeling unfold. I find it so difficult. I no the way is to go back to the body, listen to what is happening deep in me. I don’t know how to do that. it is like holding oneself gently in one’s arms. No need to say anything, just be there for oneself.

Only in the presence of a therapist do I learn this. This is called in neuroscience co-regulation.

So upset we live in a world that is so harsh on children. No enough touch, holding. To much action orientation, performing.

Hi TLC,
Thank you for sharing your experience with us here. The very thing you are talking about happened with us, too, and I felt a tug at my heart. We, too, brought up the issue of attachment to our therapist after a long hiatus from therapy. We discussed it in one session, and felt satisfied for about a day, then swollen by shame storm. Felt the need to talk about it again, but felt like it was not acceptable to bring it up, like you. It took some time to muster up courage, but we did it again….. Then again for the third time. For us, each time discussion deepened, and we leapt different insights and learned something different. Just wanted to share our experience. Thank you again for your sharing.

Hi Echo,
Yes! Exactly! Being swollen by the shame storm is a great analogy. The first time I brought it up it was terrible and then, you are right, I felt great for about a minute and then it was exactly how you described it.
Then yesterday I met with my therapist after sending him a sorta, kinda generic email about my still constant search for a father– something I have been doing since I was around 10. He actually started to ask me some really pointed questions about what kind of men I looked for in a father and I shared with him how it usually happens. I told him that I usually pick men who are authority type figures, like ministers, doctors, bosses and that I usually get so incredibly embarrassed because I can feel myself trying to push my way into their lives too much–aka get too much attention. Sometimes I can get myself to step back and stop acting too needy around a male figure– like sending too many texts, or emails or trying to be in the same place they might be, because it is so very, very embarrassing. If I feel I overstep at all, I then avoid the person completely. But I still occasionally will send one more email or text as a test…to see if maybe they are really willing to fulfill that dad role; they always fail, always– of course.
My therapist was very interested in this and asked me if I was going to start testing him– this question confused me a bit, but of course I didn’t ask what he meant because I was too embarrassed my the whole exchange. Even after he told me not feel ashamed and that what I was feeling was normal for someone who had experienced what I experienced, I could just not really continue the conversation. I just stopped talking.
I am thinking that I am going to email him and tell him that we HAVE to please continue the conversation next time. I think…
Echo, you say that you gained different insights and learned new things when you talked about it, maybe you can share what those were (if you feel comfortable doing that, if not that is perfectly fine too).
I really just don’t know how talking about the attachment is going to help. It seems pretty black and white. I am attached–I shouldn’t really be and now what?? He is not in my “real” life and most likely never will be. The really cruddy part is that I feel that if I had met him in another capacity– family friend, church, or whatever, I could keep him around forever. Sometimes I think he feels that way too, but that may very well be wishful thinking on my part.
My stomach hurts having to have another conversation about all of this with him. He has helped me figure out so much important stuff and part of the reason my stomach hurts so much is probably because I realize that talking about this probably marks the beginning of the end.

Thank you for your reply. No, I don’t mind sharing our experience. Thank you for asking. Sorry for the tardy reply, though.

I guess what we have gotten out of our interactions with our therapist by talking about our attachment issues with him are 1.) our therapist is indeed safe, and not going to take advantage of us under any circumstances physically or discount our stupid emotions, 2.) that he is human, and he can’t be always perfect, and he does make mistakes and hurt us sometimes unintentionally despite all of his education, experience and trying his best to be the best, and 3.) that we can repair the rupture – connecting, disconnecting and re-connecting if we allow it – it is a normal cycle in a healthy relationship, and we don’t have to be perfect to be accepted.

The problem we saw we had in our way for continuing our healing was our phobia of attachment. We have parts, and one of us thought it was unacceptable to be needy. From the get-go, she wasn’t going to allow anyone to get attached to our therapist because this was simply a business transaction, and it would be a pseudo-relationship that would come to an end sooner or later when therapy concludes. So we weren’t going to set ourselves up for a heart-break.

Another part of us saw our therapist as to-be-a-perpetrator. She was attracted to power and authority. She would be a “perfect” client so that she’d be accepted and not get hurt. But deep down, she didn’t trust he wouldn’t eventually take advantage of her.

These two were the initial topics of our conversation around our attachment issues. They (the above two parts of us) emailed and laid out our problems moving forward with therapy. Our T scheduled an emergency session that happened to be on a holiday. The building where our therapist’s office is usually very busy, shared by lawyers, insurance company, investment firms with annoyingly tight packed parking lots. However, on this day, it was empty. There was no one in the building, only a couple of cars in the parking lot. I walked up to our T’s suite, and I saw T arriving from the other side of the corridor; we met in front of the door. It was locked. As he unlocked the front door, he whispers, “it looks like it’s just us.” He opens the door for me, and it’s dark inside. He closes the door behind us, and turns on the lights. There usually six other therapists here in this suite, but it was obvious no one else was working that day. The whole building is empty. He made me my favorite cup of tea, and brought in a space heater for it was a very cold day. I honestly don’t remember what we spoke about in the session except this encounter. After this day, though, we knew he really wasn’t going to take advantage of us, and he is in fact a trustworthy man.

We learned that our T genuinely cared about us, too. Yes, it was a professional relationship, but it didn’t mean our T stayed indifferent and kept emotional distance. We came to learn it was quite the opposite. I don’t get into the details, but there were instances where he showed his emotional attachment towards us, and he was not afraid or ashamed to show it. We actually felt bad for emotionally cutting him off and not letting him know how we were doing for extended time. We knew we made him worry, and he did not have the freedom to contact me. Only we held that privilege to initiate contact.

After this, younger parts were allowed to spend some time with T a little at a time. Different parts came to talk about different things at different time.

Accepting that we don’t have to be perfect to be acceptable was hard, and it is still an ongoing process every day especially when a shame storm hits. Also being perfect doesn’t guarantee the other person to finally recognize us and give us what we want, either.

I hope this was not completely off topic.

Please let us know how things are for you with your therapist if there is anything new, and if you feel up for it, too.

Take a gentle care of yourself, TLC, and wishing you the very best in your healing journey!

What a great post. It helps to explain so much about attachment to your therapist in easy to understand language. Thank you.

One thing I am confused by however is where you write about sexual feelings for a therapist. You say;
“When attachment to a therapist is sexualized, I usually think that the drive comes from the yearnings and emotions described above, but that premature exposure to sexuality, in some form, has most likely occurred, leading to expression in sexualized form” I am a heterosexual female and I have had intense sexual feelings for my female therapist. Whilst my childhood was certainly unpredictable with verbal abuse and neglect I have no history or memory of any form premature exposure to sexuality. This paragraph thus confuses me…Is it wrong and I disagree with you or am I simply not remembering something?

Dear Janet, That’s why I hedged, “Usually” and “Most likely.” There is no way of knowing. In my experience, creating a safe place in therapy ultimately (usually) leads to the truth becoming clear, so I don’t think that digging for memories or worrying about knowing is helpful. One can ask the question whether, if something did come to light, one might be ready to face it. If not, then it is no surprise that memories have not surfaced. JS

I just came across your blog. Thanks for all
of the information. I am currently attached to a former therapist that I have been emailing. He has retired, but has been trying to help me. I feel like I will die when I can’t communicate with him. I don’t have any sexual feelings toward him, only platonic. I wish he was my father. It all makes me feel miserable and hopeless.

I have a diagnosis of Borderline Personality Disorder. My question is, does this largely occur in people with this diagnosis or does it vary?

Judith Herman was the first to point out that “borderline” usually means trauma survivor. Unfortunately the term has gathered up a lot of negative associations, which is one reason I don’t like to use it. The other reason is that labeling doesn’t help, while working to understand what is going on is different for each individual, and is what really helps. So I usually skip the label and want to get to work on the unique experience that led to whatever problems we might be seeing. And by the way, the people who have commented on this blog mostly only show behavioral characteristics. The real, original concept of borderline were people who had trouble seeing themselves or others as “three dimensional.” They could picture people who are all bad or all good, or who switch back and forth, but had trouble taking in the nuances of humanness. That can be a real issue, having to do with early development, but is not at all as common as people who feel intense needs for something in the realm of what I like to call primal love. JS

Dear Jefferey,
I am currently in therapy and have several significant issues to work through. I have been working with a therapist for about 10 sessions. We procured a contract identifying 5 issues that we would work on. We are on issue 5 of 5 and I’ve not heard any further talk about a formal diagnosis, or even some frank discussion about what the therapist thinks is going on with me. I thought at some point I would receive a diagnosis of some sort. I have asked the therapist about my diagnosis directly several times and I have gotten the response that the therapist “thinks my case is more complicated than that.” (‘That’ being the ADHD diagnosis) but with no further clarification.

Initially I sought help for what I thought were attention issues and general scatter-brainedness moreso than usual. I think somewhere in my medical paperwork it mentions that I have ADHD inattentive type in addition to my 20+ year old diagnosis of dysthimia. However, my sense is that there is more going on with me, and that I may not even have ADHD. I suspect that the ADHD label was an easy diagnosis to use in order to secure insurance funds (not for shady fraud purposes, but for the purpose of trying to move things forward to provide me with treatment.)

Knowing that I’ve directly asked the therapist several times and gotten the ‘your case is more complicated than that’ response, and assuming that my therapist is being straight with me in not clarifying the diagnosis for reasons I cannot know, is there ever an instance or set of circumstances that a diagnosis might be withheld at least initially, or that a diagnosis is withheld for fear that incorrect diagnosis may damage the patient in some way (e.g. not being able to get X treatments in the future, impacting the patient’s qualification for future insurance benefits, etc.)?

Dear Allen, diagnosis has been co-oped by insurance and gives very little useful information. “Formulation” is a technical word for the therapists understanding of how problems came about and what is making them stay. Or you can ask in plain English what he thinks is going on and how you might get better. A good therapist might have only guesses but should be willing to answer. Personally I don’t believe that being mysterious has a place in therapy. JS

I love this blog and comments and to realise I am not alone is unbelievable. I have a question though which has tormented me all my life. I have been in therapy twice and now referred for a third time. It is exactly as you describe – like a seed that gets watered. I have these issues you describe, my attachment to my therapist a few years ago now was torturous- but I was never abused or neglected or in care. I know my Dad did not really want a child and my mum struggles to show emotion and I think I was left to “cry it out” but they both loved me. I am angry that my inner child thinks it has the right to feel so needy when nothing bad ever happened to me. It makes me feel ashamed, embarrassed and melodramatic. Why do I hand this attachment problem when nothing has ever happened to me?
Also – should I go back to therapy- I have been referred for a phobia but it has triggered my inner child and as a result I feel like I am going mad and I’ve taken diazepam to help calm me down. I never want to go through what I went through before again but I’m scared it’s too late, the door has been opened and the seed is watered – help what should I do?

When children are upset they have a reason and need help, not blame. I think inner children need to be listened to with compassion. Not necessarily left to act as they want, but treated with understanding. When treated that way, they will do their best. JS

“Dad did not really want a child and my mum struggles to show emotion and I think I was left to “cry it out” but they both loved me.”

Dear Kate,

Unwanted + emotionally neglected : that is so wounding! Each of these can be regarded as something quite bad that happened to you. It is established these days in neuro-psychology that neglect is more damaging than abuse, in the long run…

The question is not whether they “loved” us or not. The question is how we felt, how our fundamental needs were met. A child needs dedicated attunement, care, warmth. “Love” is too abstract…

Thank you for this article.
May I ask, when the therapeutic relationship does go wrong can it be fixed or is it time to move on? My Therapist possibly gave too much, then firmed up the boundaries we have been talking lots and they have taken full responsibility for what happened. If I move on this attachment pain will surely just end up in another relationship but if I stay I think what is being said is that we won’t have to say goodbye when retirement happens our relationship will enter another phase.

I can’t quite make out what your situation is, but in general there is a very important principle: working problems out in the relationship with your therapist is the same as working them out with your family of origin. Said another way we engineer a re-creation of our unfinished business from the past in our therapy, and working it out there is the way to heal. So definitely, when there is a problem with a therapist, if there is any chance of working it out in the therapy or with the therapist, that is way better than giving up and carrying our issues to another relationship. JS

I emailed my therapist saying many of the same things I wrote here. First he said that all those feelings were very normal, he thanked me for bringing them up again, and then he apologized for not staying neutral enough and possibly encouraging me too much. I told him to stop talking, that it was not his fault, it was totally mine because I have this need create fathers out of men “in authority” figures. I have been doing it for a very long time and it always fails. I always get too embarrassed when I start getting those feelings and I start keeping my distance- except this time. This time I have fallen in deep. Now I am feeling angry. But instead of just being angry at me for allowing myself to get in this position, suddenly I feel really ticked off at my therapist, too. Like all he can do is apologize?? That means he is probably going to try to distance himself even further. And, although it does not really make sense, I feel now like this is just another example of me being rejected. If he really cared he would have said something different–I don’t even know what I wanted him to say. No that’s a lie, I do know exactly what I wanted him to say– but that’s not gonna happen.
Bottom-line, I know you have said it’s probably not a good idea to take a break from therapy but I keep thinking that just might be the needed thing. Then I can strengthen myself to be more independent again. So here I am 4 days from our last session together, trying to stay strong enough not to call for another appointment. The longest break I have ever taken from therapy with him is about 4 weeks, but that was a long time ago at the beginning of our sessions together. I am so very afraid he will not even notice– then what?
My heart hurts, I am embarrassed, I am angry, and I feel even more obsessed than ever AND it has only been 4 days.
(feel free not to post this–I feel like I have posted way too much lately, but just don’t know any other place to process this all through and just simply writing this made me realize that my main emotion this time is actually anger).

I don’t know if this is a questions about attachment to a person in therapy, or not. It’s certainly about being in therapy. I wrote that I had restarted therapy with a therapist, after a year and a half of not going, because I had gotten severely ill. Basically, I had stopped taking my medications. I felt as I felt most of the time when I was growing up as a child, and I told that to my therapist, and he said that I wanted him to nurture me. I didn’t understand that at the time, and though I am learning to nurture myself, i still find myself in therapy wanting, wanting, from him, that which I did not get in my own relationships with my parents whilst I was an infant, young child, child, teenager, adult, adult child of a (I am sure?) mentally ill mother and father from a severely abusive family of origin. My father did much better than my mother. She never received appropriate treatment. She has never had a diagnosis, and I feel like I wish she would. It would help me so much to be able to say, “I grew up with a mother that had X”. It would make the Loss-of-what-never-was” make so much more sense. To have name for what was going on.

I have toyed with dissociation. And in fact, I am severely dissociated from my feelings much of the time. I told this to my therapist, and he asked if I could feel happiness and joy. I told him, not with also feeling unimaginable grief.

Here is my question: My mind always short-circuits to wanting a hug, or physical contact. I don’t know how to connect through words otherwise. and if I try to connect with words, my mind goes to the unimaginable grief of loss. I have no memory of ever being comforted, physically or otherwise, by either parent, and yet I am a “well-nourished” female, according to the psych reports at the hospital I went to when I became so ill.

My parents must have given me something, which I cannot connect with or am critical of. And I want my therapist, still, to DO, something. He always says I am in charge. And yet at times it (therapy) feels so unwieldy, and like I want him to be able to contain what I am containing, and I feel like I cannot contain it in the therapy room.

In fact, I don’. I’m writing this to you, a psychiatrist-turned-online-adjunct-therapist. wondering how to get past this desire for physical contact of my therapist’s presence. He told me that he has a boundary, and I am trying to respect, with utmost respect, (because I ahven’t, in the past, with other counselors), that “he does not hug people”. Actually that is not strictly true. I literally SAW him hug a coworker. So what he meant, is that, he does not hug his charges.

I am one of his charges, so he is not going to hug me. Right now (not “at this moment” figuratively, but in my therapy work, I am building a wall so that I can leave his office and not feel that I have to hug him. My parents did not hug me, and he cannot make up for this. I have gotten that message loud and clear from your posts: If you want a specific action from your therapist, that is going to short-circuit. It can’t be true that him giving me what I never got from my parents (actual, real, love and communication and liking me and God forbid, knowing there was a such thing as wanting to understand me and trying to do it even if they couldn’t immediately do it. God forbid they would ever do that.)

Your therapist cannot make up for what you did not get. You have to give that to yourself. How to move forward in therapy and life after the construction of this wall between me and him, where I can no longer see or hear him, and am still faced with the monumental (seemly) task. I’m writng to you because I am so stuck, it keeps coming back to, that I want him to physically contact me. Yet on the flip side, I am terrified, defensive, and angry about it if he does, because if we have a relationship, the unimaginable grief begins to rear it’s head, of the loss of him. I have to feel the Loss-Of-What-Never-Was. I am so critical of what was, the one thing I can remember my mother doing to soothe me, because it did not really soothe me, and though in my mind, I can see it was nice of her to try, I’m angry that it did not. Over and over. I have to soothe myself.

Beth is not my givenname, but then in real life, I don’t go by my name given at birth either, so the dissociation is fairly complete. I know that you, Jeffrey, are a real person, and everyone who write here is a real person (or feels like two or three). It’s hard to intergrate, I think a hug would do it, but then how would I talk afterwards? I have no idea how to relate. Where do I begin to talk. How do I begin to feel, in the presence of another person, the actual feeling and word at the same time. I had a psychiatrist once, and she told me a word for the way I was describing I felt, but I was very dissociated, and was only telling her the words. I was not feeling the actual feeling then. I don’t seem to be able to talk and feel at the same time. Either I am talking, or I am feeling. And some of the feelings, are very horrible.

My husband, who has been married to me for many years, observed my interaction with mother yet again, this past weekend, and afterwards, he said to me, my husband who has seen this so many times, said to me, “there is a name for that’. I had no idea. I asked him what it was, and he couldn’t exactly remember. He told me to Google “parent treating child like an adult”.

I did, Jeffrey. It was horrible beyond words.

How does something like this arise? I feel dissociated from this. I don’t know why I would feel so horrible about it. I set my phone clock for 5 minutes to tell my therapist. It was all I could handle. I spent the rest of the session packing myself back up so that I could leave and carry on with my life outside the therapy room.

I don’t know what I am asking. Yes, I do: what do I do when the attachment need is such that I feel and perceive, perhaps incorrectly, but still perceive it, nonetheless, that physical connect is necessary for progress to take place and that I will forever be dissociated if I don’t get this? I know it’s not true, it’s just that I have, no words, somethings, to utter anything, and then when I lay on my side on the couch, with my back towards the other side of the room, and push my face into the couch, it’s like, he is not there. And yet when I turn around, I have to face both him and myself. And these days, I am building a wall, so that I can leave the therapy room, and continue on with my life. It feels devastating, and I wish there was a word for what my mother has, that gives rise to Emotional Incest. That is what the goodle said. and that is what it is. that is what fits. What gives rise to that? Jeffrey. I am trying to understand and make sense of it. Do you know, what makes a person be emotionally incestuous?? I know that you cannot diagnose my mother. But you are a psychiatrist, who has studied human behavior. Can you explain why my mother might be this way, and suggest (I know it is only your suggestion) of how to move forward in therapy, past the “You have to hug me or at least touch me” impasse I am facing?

Thanks for your thoughts. Thanks too to everyone who writes in this blog for sharing your struggle.

You responded to a message I had on the earlier blog. Thank you very much! And I want to respond to yours.

I’ve become convinced that those of us who experienced horrific emotional stuff in childhood might be better able to help each other than therapists can. Maybe not in uncovering stuff but when it comes to moving on and building a life. I hope so, anyway.

I can tell you what I became aware of, that caused horror and then dissociation — it was definitely horrible to me. But I’m not sure that the details are important. And my parents and other people were unaware at the time or unable to consider alternatives or believed they were doing the “right thing” because their own psyches had been numbed out. I was hurt and damaged, sure, and didn’t really know that for years. My life has largely been dysfunction and unproductive. Sucks, and sad. And then what?

I think “recovery” is too much for me on my own, and being with a therapist it’s still been “on my own”, in a strange way — not for everyone but definitely has been for me. Perhaps/probably because I never found a therapist who could overcome the wall I had already built toward my family. Even though I was somewhat aware of it. That didn’t mean I could dismantle it.

I’m more comfortable these day in the support group Adult Childrend of Alcoholics and Dysfunctional Parents, even though my parents were not alcoholic. Just started it 3 months ago, though, so not sure how that will go. They say, yes, you have to do it for yourself but with the support group, each doing their own journey, struggling with incredible and difficult, but different, circumstances, I don’t feel so alone. I hope it may help. Time will tell.

In my experience, therapists just don’t get it. Not sure why. Maybe this blog article will help them some. But I’ve been in and out of therapy for 55 years, 19 almost continuously after my late husband died. And I’m done with it.

To Melanie, Beth, Judith and readers to whom this is relevant, Beth raises the question of how to deal with the absolute feeling that only a hug will allow progress. Judith tells what happened, and how the hug felt incredibly important, but also led to more needs. I have known people whose therapy just couldn’t move without a hug, and I know this can be an extreme barrier. Melanie brings up how a support group of peers can be of real help. I agree that can be very powerful. Bottom line: I think the best answer is that it needs to be worked out in detail with your own therapist, human to human. I have sometimes said that the boundary marks where a storm of appropriate anger from long ago can finally crash up against something solid. But to put that kind of rage on your therapist may not be so easy either. I think it is most important to take the discussion beyond whether T. will or won’t give a hug, and move it to what changing his or her mind would represent. Is it about humanness? Is it about understanding the pain and yearning? Is it about the physical channel of communication and how different that is from words? Words are so inadequate and so sterile when they don’t have the emotional content that is embodied in a hug. So I think we are up against some real problems with talk therapy, and I just don’t have a better answer than to go beyond rules and boundaries and get real with your T. and expect a real exploration in return.

I can relate to the HUG me and this will solve my problem. Even though I read all the books and articles and this wonderful post and the previous ones….it still feels so real. My therapist bended her boundaries several times and like it is written here in this article it must be a dangerous thing to do but in my case thanks God it turned out to be a good thing. Just like Jeffrey wrote it actually proved to me the humanness of my therapist. Of course the next session I tried to demand more and was rejected which hurt like crazy. Now I can kind of imagine the trade of taking the compassion she has for me as a client and grieving my pain while receiving this compassion. I can imagine, yes. The only problem is that I can not feel anything in session. The only thing I can feel is shame and anxiety. Sometimes I can be calm. When she hugged me finally one day I traveled back to the mother’s womb, almost fall asleep. A few times I tried to stay in touch with feelings while talking and what happened was an interesting loss of my cognitive capabilities. Its like the hidden emotions block my mind and I could not think or speak or even understand what she was saying. I literally had to ask her to repeat things three times as I could not understand a single word.
What worries me is like you Beth I feel a bit stuck. I dont know if I will ever be able to do this trade and to actually feel safe enough in the therapy room and do the job of grieving. I never had a tear in therapy, ever! I cried a lot back home and I can cry as soon as Im out of there, but there Im blocked.
Also a few times my therapist apologized for something that she must think has done wrong with me and I cant take it. I literally can not process the information what she says. She says I am sorry, that……and than I do not hear the rest. I think it has the same roots. Something is way too painful, wants to come up but Im not ready or Im surpressing it. My goodness how long does this have to go on. Im in my 5th year.

Last session we agreed that I come only after 2 moths and that I can not come until than because I told her that my anxiety drives me crazy about when should I have my next appointment. For a while now I dont go regualry but I go when I feel. Now she set boundaries and it is much better. However Im really getting impatient with myself as when the hell will I be able to let go of the fear and let my tears run when Im there and not just suffer alone all the time. 🙁

My two cents on the topic of hug and healing from early childhood trauma is that we have to deal with (or engage with, in my case) our body sooner or later in order to completely heal. Dr. Bessel Van der Kolk talks about the effects trauma has in our body in his book, “Body Keeps the Score”. (Thank you, Jeffrey, for recommending the book!) Our therapist gives us hugs and he touches on our shoulder when he wants to show that he cares. We are from a country where a hug (or even a handshake) is not a part of social interaction. A part of me receiving a hug from our T in a therapy session was the very first time anyone touched us for the first time in our life outside of our abuse experiences. Because we used to be so dissociated from the body, we had trouble acknowledging that we had a body. The body itself used to be a trigger, and we couldn’t even do a body scan (didn’t even understand it since we didn’t own a body!), let alone, a simple breathing exercise without flying into an anxiety attack. We couldn’t feel anything when our T touched us. We couldn’t feel “supported” emotionally by a hug. We knew in our head as a fact that the action is meant to show emotional support for the other humans, but we didn’t “feel” it until we learned to integrate the body (the vagus nerve or the tenth cranial nerve/parasynthetic system) and the mind.

I learned that different people have different ways they perceive “love” – some people, their primary expression is words, other people, it’s physical touch, yet other, it’s quality time. As for me, it’s action. Our T seems to show his affection and care by the time he spends with others and by physical touch. Physical touch isn’t very important for us, but we couldn’t ignore the effects trauma had on our body. If we felt physical touch were a big component in our healing journey, I think we would have gone to T who practiced sensorimotor psychotherapy (Pat Ogden). They use touches in their therapy practice. Or those who practice NeuroAffective Relational Model. The very notion of any physical contact terrified us, so we avoided these practitioners. But I wished I tried. Our healing journey might have been shorter, and it would most likely be less re-traumatizing after all.

Any how – for those who are still in the early stage of therapy, I hope you’d explore the options, and what’s available in your area.

I don’t know if anything I write is ever helpful to you. It’s freaking uncomfortable, but I think being angry at your therapist is a good sign. I have been working on-and-off with a therapist for 3 years now; it’s the longest I have ever worked with a single person. I have gotten angry and fired him so many times, because I had something to work out. Right now, I’m a little angry and frustrated with my therapist, because I want him to make my childhood pain GO AWAY, and I feel like I want him to just do it, without me having to talk about it and feel it. Part of my childhood pain is a huge disconnect, from myself (I felt invisible growing up) and therefore from other people. Very anxiety-provoking, and very painful.

You wrote that you were violated by an uncle when you were younger. That is a huge trauma to your sense of self, I am sure. I was emotionally violated by my mother in addition to weird sexual stuff about her, and it is very rough. One thing that helps, and I feel like helps resolve anger toward the therapist, is to start re-establishing, or establishing for the first time, boundaries for yourself. Boundaries are defined by Sonia Connelly as “being able to say “yes” and “no” to state your preferences about what you want.” You don’t always get what you want, but no one should ever violate you.

What are some things you enjoy doing when you are not with your therapist? Do you like coloring? Cooking? Listening to music? Playing basketball? Sometimes when I am doing these things, I hear conversations with my therapist in my head, and I don’t like it. I found that wearing earplugs helps stop that and lets me focus better on what I’m actually doing.

Mindfulness helps.

Neglect and abuse suck. Healing from them is really hard. I send you positive energy for setting boundaries and being able to soothe yourself when your therapist cannot.

Hi Beth,
I have read and try to process what you have written to me here and on previous posts. Honestly, most times when I first read what you (and others, including Dr. Jeffrey) it makes no sense, because maybe my brain won’t allow me to process it yet— for whatever reason. However, sometimes I go back a reread and then go “ahhhh, now I get it!”— total ahah moments. The part about mindfulness definitely rings true in that regard. I do OFTEN hear my therapists voice when I am doing something enjoyable, for me that is running, reading, hiking, baking and just anytime I am in solitude (I love being alone). This drives me nuts! I hear him while I am driving the worst. Of course the alternate to hearing him is me berating myself. Hmmmm…neither is that great really. I may try the music thing, I do that in my car often— just turn it up so loud I can’t hear any of the voices. It does help, but it also seems to mask something.
Your talk of being invisible struck me solidly. I felt that way often as a child. I was child 5 of 6. My dad did not want more children, but mom kept having them. I was also supposed to be a boy— so I totally became a tomboy, I even wore my younger brother’s clothing— which still didn’t help. At age 7 or 8 I used to run away from home on Saturday mornings to see if anyone would notice— they never did. Then I would come back in the house just after dark and no one would say a word. Invisible is probably too strong a word, maybe just overlooked. I don’t think anyone intentionally did this, I was just a very sensitive child. I cried a lot and pouted a lot and that wasn’t something that was allowed or accepted or welcomed. But I just couldn’t help it. My parents just parented very unintentionally. My physical needs were met, although we had little money, but my emotional stuff I was sort out on my own. I started to find jobs at a very young age so I wouldn’t need them anymore, I guess. By age 10 I had a thousand dollars in the bank from working, by age 16 I had 9 thousand, I still have an obsession with work and money. I never feel I can work enough and I never feel I have enough money. In fact, the time I feel absolute best is when I am at work and I have no time to think. I work very long days and in my field the work is never really done, so I have perfected the workaholic thing.

You wrote that anger is a good thing, maybe. And maybe it is. It is easier for me to be angry- it’s an emotion that I am good at. I never feel guilty about being angry. I should probably,but I don’t.
I just want him to fix my pain, too. I think you wrote that as well. Something interesting I thought of as I was thinking this through this week is that I believe the reason I am so attached to him he is the same age approximately as my dad was when he died. I think I freeze myself in that age range too. I was 25 dad was 62. My therapist is 62 and I am no longer 25, lol. But I often feel stuck in time right there. I have felt very weird and shamed about why I felt a father attachment to someone not really old enough to be my dad. I can maybe put that problem to rest— makes me a bit more comfortable.
And finally, yes, this type of childhood can really mess with a person’s emotionally well being. I tried very hard to parent the opposite of how I was parented, but so much of how I was parented came out in how I parented. I wish I would have known or realized the connection sooner, so I could have parented even differently. My desire to parent differently was not even cognizant; I just did it because I hated my childhood so much. So I overparented and loved too much and protected so much. But sometimes I fell back into the same patterns That my dad used, ignoring and anger(sometimes rage) which was confusing for my own children for sure. I feel much, so much guilt about this and it is actually my greatest regret in life and will always be. I am not sure how I will ever fix that one either. They love me so much and they know I love them, but I wish I could have been different for them. I know I’ve screwed them up in ways too. Blah! Hate that part.
I just sometimes don’t know how talking about this crap is gonna help any more… it is what it is. The pain is still there, it’s not going away and what else can help? I’m not trying to be fatalistic, just honest. I feel like I can hash this all over with my therapist just so many times and then shouldn’t I let it go and move on? I hate that I can’t and that it has always, and continues to be in the front of my mind whenever my mind has a chance to be still.
Finally—
I am at 14 days of no contact, and feeling more and more like this is stupid— but that damn kid inside of me won’t give in. She is a stubborn beast. She really wants him to contact me first and I am having a hard time not listening to that voice because I am really hopeful. The problem is, I just know he won’t do it and I deeply fear that rejection right there.
(Thank you all for allowing me to process my thoughts here. Appropriate or not, if I know someone is reading, I can write these things down instead of having them swirl and swirl and swirl in my noggin.)
Oh, one more thing. Beth you mention you are not really Beth and that you do not go by your given name in real life. Coincidently, I have always hated my given name because one of siblings gave me my name— meaning, in my mind, that my parents didn’t even care enough to name me…and I’ve just started using a nickname for myself. I just found that interesting.

Thanks Jeffery for your answer! It is very helpful. Sometimes I do feel that talk therapy is just not enough and my T did say that sometimes there are issues that can only be resolved by a real hug. I think I got everything I could from her in this respect and have to admit there is no more coming and I should be happy I got this for myself. Also hard to bear the knowledge that she does touch therapy with others as I have friends who see her. A friend who actually is on the opposite scale than me. I am the anxious one, she is disconnected. Im hyperaroused, she has no connection with her feelings, so she needs to establish more closeness, while I need to establish more distance, I know. Of course I feel the opposite way, but I know that actually what I really need is safe and firm boundaries to feel safe in the relationship. It is up to the T to set those boundaries and Im honestly think we are just getting there after 5 years. I do think that her personality interferes with my problem, too but that I can not know for sure. So it is really a work of two human beings, I can see that now. I know she wants to help me and now I feel like I have to provide her with more information even though it is still very hard for me to talk about these things as I have all the shame around it still, but I must talk more, so she sees more clearly. So many sessions, so many years and the last time when I talked more in detail about how I feel she was shocked. Of course…she cant feel what I feel but how come she did not know after 5 years asked a few people around me with whom I talked about it. My only answer is: 1. I did not talk in enough details and 2. She is differently put together than me, she is not the anxious type I guess but the disconnected type with an earned secure attachment. So she will never fully understand me. She will fully understand the same type. It is hard to say and maybe foolish to say to because I lock myself up in a box with a statement like this…so I will always feel she does not understand me. But the problem is that I must say this out loud as I felt it already way too long.

So I think after a while of not being able to get closer and turn a T into a mother….one starts to feel some kind of rage and anger and because of that will start to build a wall….which practically can be translated to YOUR BOUNDARIES. Im trying to do that. The last session I said to my T: yes, I understand your boundaries, you have your boundaries… and in return she said: and you have yours as well. Or something like that and I remember it felt really strange, that oh well yes you are right…I exist too. Lets not forget that! 🙂

So sorry I have been messy with my writing, probably no too coherent this time. 🙂

i’m usually a lurker, but reading these comments is heartbreaking..
i’m someone who has tried therapy several times long term & finally given that up,
like others have said here i imagined perhaps we attached might find support among each other,
so i ran a forum for couple years to that end. as someone who is very dissociative i feel much
more present through the internet using my blogs & art gallery & commenting like this than i ever
felt in person, i also never cried, in fact sat astonished as i realized my own therapist was
tearing up over things i was saying, but i was too dissociated to feel there. i was called stoic,
while at home i felt shattered & like a basketcase, completely alone.

a friend i know got her hugs, end of every session, it did not fix the issue.
there are no testimonials.

i believe we still have a long way to go to find how best to treat this situation as it presents with some of us, i have always had an avid interest in psychology & i still believe in the value of talk therapy, but have chosen to figure this out on my own because i found real help to be unavailable. dr smith has been the most open i’ve encountered, making a place for this conversation, & i appreciate that.

I feel your sadness which is sitting on your writing like a cobweb. I felt very sad reading your post. However I believe there is hope. I never gave up and never will give up on myself. (not saying you did) I might give up on therapy or I might give up on other things but I will never give up hope for my own wellbeing. Thanks God Im a very optimistic person.

I have been around, I have read many forums, but the single most helpful one where I keep coming back is this one. The people who post here are so real, Jeffery and his writings are so real! I would sincerely like to thank everyone here for your support because it really helps!

You know we are not stupid, we are not wrong, there is just something difficult for us to face. I had a tiger licking my face a few days ago in my dream. I was scared to death. I have fearful dreams nowadays. I get threatened to death or I kill. There is change happening. There is something happening that I am so afraid of. Change is scary. I think Im getting closer and closer to my trauma. I hope so and Im so scared at the same time. I know Im going to survive. Good luck everyone and hope to read more, please keep coming back!

thank you for your kind reply.. & i’m sorry to have come across sounding so grim, like you i am still a hopeful optimistic person who believes the answer is there even when we are not able to see it clearly.. i also thank those who comment here & offer my support..
in spirit 😉

This is just a general question on the topic of attachment: has anyone here read a book titled, “Attachment Disturbances in Adults: Treatment for Comprehensive Repair” by Daniel Brown Ph.D., and David Elliott, Ph.D.??? Just curious…

I was happy to read your comments to what I had written. And I think I understand, how lucky you are, in a way, to have a therapist who cares to try to meet all your childhood and possibly adult needs. It occurs to me that I was in a relationship with a doctor several years ago where I did a similar thing. I indulged in her caring and began to rely on her. One thing I have learned would have helped me is something called “grounding”. It is a way of being in touch with yourself, no matter what you feel, and whether you are anxious, disconnected, or something else. There are a lot of ways people use for “grounding”.

My favorite one was taught to me by a psychiatrist. He suggested starting at the head, but I like to start at my feet.

Starting with your big toe, let your mind have it’s awareness of your toes, your feet, heels, legs, moving on up through your torso, and neck, and finally to your head, and the top of your head. You can even let the stress pop out the top of your head like a porpoise blowhole!

It is hard to do at first. When you have more practice, you can look on the web and google something to do with “grounding techniques”.

The more aware you are of how you are feeling, the better you can talk to your therapist 🙂

I am having trouble with my T. because though I feel grounded in myself, I’m not able to open up to him. I keep dissociating away from how I’m really feeling when I am in the room with him. It makes for dissociated conversations. Sometimes, I have rebound anxiety from talking over my feelings. I talk faster than I can process my feelings, and the result is almost unbearable anxiety. Going slower, remaining grounded even though it’s hard, and not talking about more than I can handle reduces the rebound anxiety, even though I can still feel very distressed about the feelings that come up.

I asked TLC, and I’m curious about this with you, of what you like to do when your T. cannot soothe you?

I have learned to enjoy coloring, for one thing, and also drawing pictures that have psychological meaning to me. I am often focused on wanting my T., and depending on him to soothe me, which he can’t always do. Then I am frustrated. Then I color, and sometimes I cry, which seems horrid when it is happening, and sometimes like “it will never end”. I literally feel like I have cried an ocean and learned to breathe underwater like a fish.

The doctor I talked about earlier, eventually rejected me when my difficulties became more than she was prepared to handle.

I’m now working with a different person, a therapist, off and on for 3 years now, and he has not rejected me though I do not trust that he won’t, and so I have fired him so many times. I hope you’ll be able to have some good interactions with your T.

Here is a person, who goes by Judith :). Im doing a lot of walking to try and take my obsessive thoughts off my T and my therapy. So much that my knees started to hurt lol. I don’t know where this is going, but I hope I will be able to deal with this soon. Now Im going only like once a months, or once in 2 months time. Its like a drug. Im telling myself the story that I need to be able to feel there in the room. That I will only be healed if I have a secure attachment to her which is not the case now for sure. But if its not the case in 5 years, than will it ever be the case. Is this because she is involved, like there is some kind of countertransference going on? I got to think that maybe its not possible for me in this particular relationship, for one reason or another, to get a so called earned secure attachment. If this reason is in the personality of my T it will be very painful but might be the key to the door. If I’d realize this earned secure attachment is not possible for me, maybe than I will start the real work, the real grieving and this will be the solution. To grieve what I cant get and finally get it, or get some of it. This is called the paradox of change. When something is possible only by the letting go of its very possibility. OK. this is all just my mind. Im trying to understand emotions with my head. Im really trying to feel instead of thinking all the time.

I loved it when you wrote “I have cried an ocean and learned to breathe underwater like a fish.” I feel exactly the same. I even had a dream where I could breath under water. 🙂 I have cried so much.

What elso do I do. I drink. 🙁 Not much. but I do. I live alone and I hate to be alone. Im 41, never had a love relationship, a long term boyfriend, I just don’t have the courage or I did not have it to do dating. Or maybe I wasn’t lucky either. I will try harder now but I feel like Im ugly and nobody wants me. I was bullied a lot when I was little, so didn’t develop enough self confidence. I think most of my friends, and I have many friends, would be shocked to read all this about me. I don’t talk about these things to friends. There is still a lot of shame around it. I hate to be alone in the evenings. I function perfectly in the outside world, Im a very outgoing person, I do lot of interesting things. I have a good job, so not so many people know about my struggles. I should talk about my problems more. 🙂

I have recently started therapy, 3 months ago and I am really new to all this. But find myself constantly going through the net hoping to find out information about the way I feel. This is starting to consume my every being !
I understand about transference but my question is my mother was really cold and heartless, she never had any attachment with me, never spoke about love or any physical contact. I look at my therapist as a substitute mother and want her to be everything my mum isn’t and whT I wished she had been.
It’s obviously difficult for me to understand all this but I can’t help the way I feel the way I am during my sessions. And the most amazing thing that happens is when I am so stressed I end up freezing, ,my hands feel locked in motion, my words have disappeared and my breathing becomes laboured, then in a flash everything just disappears as my therapist places her hand onto mine. In an instance I am relaxed and calm. This is the parent I long for, I so desperately want and need.
Is this transference even though she does nothing that my actual mother would do ???
I feel so guilty, embarrassed and almost dirty needing this kind of support from her.
Please help me understand all these emotions……. Please….

I was really glad to hear from you. That is a lot of stuff that went on in your childhood. It’s so hard, when you have the feeling that “nobody cares”. It seems like when you don’t have this as a child, you have no foundation to return to as a buffer. You sound like you feel how I feel, too: acutely wanting a feeling of bonding with someone who is an adult. My therapist is younger than me, but I have so many child feelings for him that in practice, he is like an older adult to me at times.

I can’t ever seem to feel bonded, with anyone, the way I imagine. Sometimes, I’ll feel good for a brief period of time. I am slowly learning how to cope with and move through the rest of the time, when things feel chaotic inside and I want a soothing adult, and it’s not the therapy hour, and it’s not time for my psych appointment, and it’s not time for anything. I’m just left with myself and that longing. I don’t know, if it will ever get resolved. I do have hope, because things have gotten better in recent years. I just don’t know when or how, even though I used to construct elaborate scenarios in my head of how that longing could be satisfied, and even try to make them happen. It just doesn’t work that way…

My invisibility came in kind of the opposite way to yours. My mom basically made into her workhorse, confidant, and psychiatrist. I became who I perceived she (and everyone else, for that matter), wanted me to be. I, too, responded to the stress of neglect by working extremely hard. I hold an advanced degree, however, after graduation with that degree, my feelings of being shattered surfaced, and I never really did anything with it. Basically, I hit rock bottom, and I shattered, and the rock shattered. I am still picking up the pieces and trying to put them together 3 decades later.

I feel like I can say, keep trying! One thing that I’m finding helps is to slow down the sessions. I used to talk over my feelings in an analytical, reporting type way, and then I would leave and feel the most awful rebound anxiety, that I tolerated only by virtue of the fact, that I am alive. I have learned to slow down. Talk less, feel more what is going on in my body, and allow myself to feel the therapist’s presence. This is really hard, because I don’t trust it, or myself with it, because it’s only for an hour, and I have to pack myself up, and leave. I had my husband record something on my phone that I play at the end of the session sometimes to “ground” me back. I also play snippets of music on my phone, to help with transitions. And finally, I set the timer on my phone to talk about things for certain lengths of time, that are emotionally manageable. Sometimes, that is only 5 minutes.

About the voices – your therapist’s, or the critical ones. I learned, to find out who the voice is, and then ask, how he/she is trying to help me. My therapist said that my voices act terribly, but that they are trying to help me, even if they are not doing a very good job. I used to have a voice that screamed and screamed in my head, constantly. I found out she was a 5-year-old who could not talk. No wonder she was distressed. I learned to talk to her, and listen, seeing her in my mind’s eye, and find out what she needed, and give it to her if I could. I even drew pictures of her.

I heard the part about tuning out the voices being missing something. Maybe you are, when it’s your therapist’s voice, missing his presence? I’m curious if asking his voice how he is trying to help, might help.

I like hiking and baking, too 🙂 Recently, I made up a couple of cookie recipes. It was the first time ever that I really paid attention to the ratio of flour:baking soda/powder:oil:liquid:sugar that was required! And they turned out pretty good!

I understand at least somewhat, the pain you describe feeling for your children, over what you say were your parenting mistakes. It sounds like that is another opportunity for you to get down on yourself, rather than knowing, you did your best. I know, it could have always been better. I have two children. The oldest, I gave up for adoption at birth. Her adoptive life was not all roses, and I sometimes feel quite sad about that. The child I raised, certainly has had a lot of struggles to deal with, partly because of my problems. Yet he is a wonderful person, I have to admire him for who he has and is becoming. I’m just saying that beating yourself up for your mistakes takes away from the joy at what is, and I think it kind of prevents you from moving forward. I can often have a sense of loss because I never felt bonded with my youngest when he was an infant, young child, or early teenager. Our relationship has gotten better the last couple of years, something for which I’m grateful. I am just saying, try to be gentle with yourself. You said that you love your children, and that they love you. If there is something you feel you can improve in your relationship with your children, or something you want to talk to them about, I encourage you to try it. My sister has recently been thinking over her childhood and how it influenced her parenting, and thinking of all her mistakes. She talks to her two grown children about these things. She says they don’t just dive into the conversation, but she feels a dialogue is beginning. I feel like its hard to talk about things sometimes, especially to start talking. Usually it gets better.

I am wishing you an exchange of the tension it sounds like you feel, for a sense of peace with your therapist and yourself.

My apologies to all for the time it takes to approve your comments and fret over not having the time to respond myself. I’m a bit overwhelmed, but thank you all for keeping up an important dialog. Jeffery

Don’t fret over whether or not you have the time to respond. Rather than fret, respond. If you don’t have the time to respond, or you need time to think because of the overwhelm, that’s a good thing to know. Thanks for the note, of what you wrote is going on with you. But don’t fret! Never fret, except on your guitar 🙂 I will say, that I for one, love hearing from you when you do have the time to respond. Any relationship like this, with an “adult”, or therapist, where the person (seems to) listen and understand, means that positive attention is very – welcome and rewarding. I just thought you would like to know that. I know I wrote once, writing in response to another poster (Melanie), that I was pretty ANGRY that I asked for your thoughts, and did not get them. But you explained about the demands on your time, and that it was not, unfortunately, me. That’s because if it were me, I could have an opportunity to change my ways and do something about it 🙂 So knowing that you have a lot of demands on your time is something I could have maybe thought of myself, but having you explain it, it is something I can perfectly easily understand. I am an adult too. Though I don’t always feel like it. And as an adult, I have a lot of demands on my time, too. So I get it, completely. Thanks for explaining that when you did, and thanks again for the note telling what’s going on.

I second what Beth said – I’m not the most consistent/dedicated visitor here, and I only have time to come visit once every other week or so. And that’s when I even remember to check. It’s not that I don’t care about the blog or people who contribute here. If I get notified that people are responding, I’d most likely make the time to visit. Otherwise, it’s probably not on forefront of my mind.

Your April 2 comment was so direct and just spot on. Also, I can feel the intensity pouring from these comments and decided to share some thoughts.

You said…” So I think we are up against some real problems with talk therapy, and I just don’t have a better answer than to go beyond rules and boundaries and get real with your T. and expect a real exploration in return.”

I believe this is exactly what we’ve done in my therapy (extremely hard, scary work). I ‘quit’ frequently. I think a lot of therapists are scared and just don’t know how to handle such intensity. I had no idea what was in store for me either. It’s not been easy at all and incredibly hellish at times. I just NEEDED a hug (please, please, please) and he just would not go there. He explained why and I understood but could not accept it. That was crushing and it was a form of rejection (massive issue for me) even though he explained it was not a rejection. Rules and boundaries need to be flexible depending on the people. Rigidity can do more harm than good. You’ve even said sometimes the client just needs the hug. The deprivations can run deep and an authentic hug can be very curative, much more than words. So, I know he put a lot of thought into how to deal with me. Getting real with each other is incredibly important and part of the healing. Seeing and feeling the humanness in each other makes for a much stronger and authentic bond. It really is energy/electricity being exchanged through the power of positive touch. I know he’s been very cautious with me in certain respects. One day he decided to give me a hug for the first time. I was not expecting it at all and he scared the wits out of me. It was a millisecond hug, shortest, stiffest one in history. Next time, he was going away for a long time and he hugged me (I saw that one coming). I floated all the way home. I know he feels safe with that level of touch at this point. Now, we mostly hug after a very difficult or powerful session. Sometimes they are simple and sometimes they are tighter, which is very therapeutic for me, because I know the connection is real. He says now that hugs are easy to give, and I’ve learned to ask for them when I need one…..a miracle in itself. It has worked wonders for me. I also know he can’t give me everything I want, like moving in with him or living in his back pocket or under his desk! It’s just not possible and I (the kid too) am learning to accept this excruciating truth. That kid is not going to get certain wishes met but she has received lots of very good stuff. She runs the show a lot but integration is happening. What I want some readers to know is that the experiences we had in younger years can be accepted, radically. Nothing is going to change the past. The therapist can’t change it either. Therein lays the CHOICE to make a choice and decide if we are going to let the inadequate parents/caregivers, etc. take our power and chain us to them for as long as we live. They did enough damage and we don’t have to let them destroy the remainder of our lives. The victim mode will kill us. I see it in my family and have been blinded by it myself. I am in the choosing process now and getting tired of thinking they still have power over me, they DON’T, as long I make the conscious choice to take my power back. Although, at times, I am haunted by them. I’m working through it all now, but they are not going to define the rest of my life. I am. I am trying with some excellent help. P.S. Your articles are excellent, especially the inner child papers. Thank you.

It has taken me a while to respond to you because you wrote that you have left the therapy relationship. You wrote that you are finding growth and support striking out on your own, in various kinds of support groups. I didn’t know how to respond to that, because I felt like it was something you resigned yourself to. Like it was not the fulfillment of your dreams, and you are frustrated. I feel like I wish that you could, have a person to talk to. I have been to over 75 mental health professionals in my life so far. Most of them, I went to only 2 or 3 times, because I perceived, that they could not help me. Some, I would say, only exacerbated my pain, in their well-meaning attempts to relate. You write of the “Wall”. I have experienced a wall between me and other people, and been given medications because of my behavior and complaints about it.

I still feel very alone at times, but I am becoming more able to cope with that scary and angering feeling. Oddly enough, like TLC, I enjoy solitude immensely. But I complain about how I sometimes feel when it seems like FORCED solitude. I’m learning to accept and work with even that.

I just wanted to reach you in words and say that if you feel bitter, still, keep looking, and maybe someday you will meet a person who is able to sit in front of your wall, and hear your silence or your strangled attempts to communicate, whichever it may be.

Judith, I wanted to say to you, too, if you are reading this, thank you for what you have written, and written to “ghost”. I want to say, that you give me hope 🙂 Since I’m leaving the post, and we had exchanged thoughts, I wanted to say thanks for what you have written.

Jeannie,

Thank you for your post. I think it is the last I am going to read for a long time.

Jeffrey’s suggestion that there can be more to therapy than just talk, along with your post, has helped me to bring about a change in my approach to my therapy, and therefore, my therapist. I wrote in response to TLC, that I used to talk and talk and talk in an analytical way, about my feelings, rather than experiencing them.

I have learned to S-L-O-W down, so that I can do what they say is “to process a feeling or feelings”. That means to feel the feeling and also to observe and think about it, and possibly change the way I am thinking about things. My therapist, my T., as therapists are sometimes referred to in writing, has a cognitive-therapeutic bias. He is not, a touchy-feely sort of person, I think, it’s my perception, that he would likely mix hugging with sexuality and so just doesn’t work by physical contact with clients. I am not going to seduce him. I am going to respect his boundaries. This heightens the task of therapy. I have hauled off and hugged a therapist before, who could not talk to me. So my current therapist CAN talk, which I currently see as a limitation. But I feel, he is in it with me. Now, I feel that way, though ironically enough, I may have to soon suspend therapy for financial reasons. There is no end to life’s challenges. But I am learning to meet them better.

I took Jeffrey’s advice, to begin to talk about what it would mean, if my “T.” changed his mind. In my most recent session, a few days ago, I began to talk with that in mind. I did not get very far! But I did break down in tears, which was, well, very therapeutic. To be able to cry in front of him and not feel like I had to explain it, or be FORCED to communicate in words, though he invited me to, was very powerful, and I feel like I’ve turned a corner in therapy, in making it feel, more REAL.

I wrote, that yours is the last post I’m going to read for a long time. This is my last comment, for a long time. I’m stopping the electronic way of relating, and forging ahead in therapy, with actual person-to-person? attempts at communication/contact.

I feel like in your description, that your therapist also enjoys hugging you. That seems unwieldy, to me. Like he is getting personal gratification from the relationship, not just providing therapy for you?

I don’t know, where exactly, my therapy is going to take me. But I feel that I have a lot of potential, and that in therapy, I can sort out and correct the limiting factors, and either overcome, or make peace with them. I also have autism, which complicates things even more in terms of touch and sensory integration. But at least I understand this much about myself now.

So I am leaving electronics for now in an attempt, to get more real with my therapist. I have emailed him countless, countless, emails, and sent him half as many letters via the postal service, of my pain, distress, and even my agony. In my most recent session, following Jeffrey’s suggestion of how to move past the “I have to have a hug or at least a touch”, impasse, I feel that I have stepped squarely out of my electronics and into my therapy room, to find, there is a person, of whom I am so very critical, who will actually continue to talk to me. I could not respond in words. He can, apparently.

I want to say, to TLC, if you are reading this, that it’s a hard and torturous life sometimes. I feel I will miss electronic contact with you most of all, even though we only shared a couple of posts together. I am glad I got to know you for an instant of time. If this were not a focused blog, I’d write to you again, about baking, and where you hike, and whether or not you have any pets. If ever I return to this blog. Which I might. Because I have quit and returned to this therapy so many times. I think at last count, my T. – my therapist – said I had fired him 50 times. Lol! He must have “good ego strength”? if he can tolerate that, and let me berate him for his failures, in person, and still, and still, and still, continue. To put up with, my shenanigans, which are a valiant and seemingly hopeless, attempt to establish communication. And I feel, that with the help I have received from reading, listening, writing and working with the responses to posts on this blog, I’ve got a start at real communication.

I’m just saying, Good-bye for now, because I care about the people who post here, and I don’t want you to wonder, where I am. Or maybe you will wonder, but I wanted you, and Jeffrey, to know what I am doing. If I run into another struggle, I might be back.

Take so much care of yourselves, and into the non-electronic world I go.

Beth–
What a bittersweet post. I am not sure your departure is a good idea or not, but you have clearly given it much thought. I am hoping that you are at least reading a few parting comments before climbing into the “non-electronic” world. Your words of affirmation about me warmed my soul– I felt a connection with you as well. I am not going to spend tons of time responding to this, for obvious reasons. So let it be known that your words of wisdom on here have been helpful. Although I like reading your thoughts on here, I actually hope you do not come back because that will mean you have not met with another struggle.
TLC

Dear person who goes by the name of Beth, 🙂
Thank You for your kind words! Maybe I am a bit selfish but I wish You come back sometime but to tell us that you had a breakthrough in therapy! Or just that you need a little support and to write a post to us. I totally understand your decision but please be gentle to yourself and if you feel you need virtual hug, than just pop in. 🙂
All the best until than!

Best of luck to you, the person who went by the name, “Beth”. I didn’t get a chance to interact with you in person, but your words will live on here, and you will continue to inspire, encourage and touch others to come and follow your footsteps.

I ended up making an appointment for next week, but my therapist actually had an appointment open up this morning. I just returned from that appointment. We talked almost (almost…) completely openly about my feelings for him. I started to talk about the feelings by bringing up the fact that I noticed myself trying to get father-like attention from our minister again this week. Not in a weird way, and he probably didn’t even notice– because I am very careful about how I do it. But my therapist totally ran with it and would not let me weasel out of talking about it. The last couple of times the issue has been brought up I have totally shut down– the feeling of shame is so enormously overwhelming. But this time, it was like he was reading my mind and he said the “right” things and asked the “right” questions and this was salve on my heart. Some (at least the top layer) of the shame washed away. I guess if I could not have a great dad in my life, a pretty great therapist will have to do. However…it does make me still wonder how I will ever stop wanting to go there– just being 100% honest.

Also, I am not sure if I should back off visits at this point. I had been going weekly or every other week for about 9 months now. Maybe I should start only going once a month now or at least not weekly anymore?? Anyone have an idea about this? I keep having this need to be sure I am ready to leave him and not overstay the time I should be in therapy. Honestly, I feel I have already spent too much time there (nearly 3 years–ugh).

Again, this blog has been indispensable in me understanding my journey. If I were a teacher of students who were getting their social work or psychology degrees, I would require them to read and report on patterns and noticings. So very much can be learned here from patients and therapist.

Farah,
What you’re feeling is completely “normal”. It is extremely powerful, uncomfortable, confusing, consuming and rattling to have those unmet needs and wishes peek through. Some of what you wrote sounds pre-verbal, like what you felt before you learned to talk. Read Jeff’s inner child articles. I think you may find them extremely helpful and maybe you will understand what you are experiencing. What you’re feeling is not off the wall at all. Shame is extremely powerful. Don’t be embarrassed either. There is nothing ‘wrong’ with what you are feeling.Talk to her about what you are experiencing and it may take some of the intensity away. I wish I had done that sooner in my therapy. It is so difficult to speak my truth, but I’m learning. Hope you feel better.

Thank you so much for your kind words, they brought tears to my eyes. I will definitely read inner child.
I go twice a week to see my therapist but find that those in between days can be so hard. I keep a journal and will often send her an email, although she won’t really say much as she said it would be like doing therapy over emails but she will acknowledge receiving them which gives me comfort at least I can share my thoughts with her.
Thank you again, just knowing someone is listening is supportive means the world to me.

Hello-
I’ve read all the comments and have been at each and every place each one of you writes about. Therapy and the therapeutic relationship are extremely challenging to navigate. I’ve been in therapy with the same therapist (my 1st therapist ever) for the past 4.5 years. The push/pull is real. I am so grateful I found this blog early on to help navigate the journey. Jeffery and Tales of the Boundary Ninja have been my saving grace…here she is- may her blog along with Moments of Change help you to continue the journey to the lives you so richly deserve!

In my experience, therapy is like a journey, only there are many deviations from the original route! Like with any journey, we encounter things we didn’t anticipate – attachment to T is one of those things. But keep travelling, enjoy it while it lasts and while you need it, because for sure, things change, they sometimes just take a really long time – childhood, being the child, lasts a long time after all. Set goals, but have no expectations of yourself or your inner child. Just let be what needs to be. Live in the moment and enjoy it.

I googled my therapist and found a news article that she was a victim of domestic violence, the article was actually about her husband who is a public figure. A little more digging and her family actually reminds me of my family of origin, like I would be playing the role of her child with the violence and divorce etc. So far she hasn’t mentioned one word about her personal life. I feel weird knowing this information. Should I bring it up?

Reply to Tina, 4/20/18: Therapists are professionals, and (should be) prepared to handle personal things in a helpful way. If something is causing feelings and reactions, it should be talked about. Maybe the biggest principle of therapy is allegiance to facing the truth, whatever it is. Jeffery

Hi Jeffrey, Tina.
A mutual acquaintance told me of a tragedy in my therapist’s life. At first it didn’t seem relevant -so I thought it best to respect her privacy. But in time, it became “the elephant in the room”. I felt somehow dishonest from being secretive about it – and, although terrified, I decided I had to mention it.
Why terrified? Because I was convinced that I would either upset, anger of have her terminate therapy with me -none of which I wanted, as she has been helpful.
I was sooo relieved when she thanked me for being open -and is happy to continue therapy with me.
But, here’s why I believe it’s appropriate to own up to your therapist……
Afterwards, I wondered why I was so convinced that I would be punished by her? I then thought of my family of origin – where we were never allowed to bring up the elephant in the room (my father’s alcoholism) -AND the most important unwritten rule was that you couldn’t hurt anyone’s feelings – it was the worst kind of behaviour! Once, under extreme stress, I told my Dad I was unhappy because of his excessive drinking (I was a teen-ager) and he refused to talk to me for two whole weeks. Is it little wonder that I assumed my therapist would punish me? So pleased she didn’t !

Wow. It’s like someone has been reading my mind and my most shameful thoughts and then wrote a post about it.
I’ve been pretty self-aware regarding the inner neediness and the shame I feel about it for a while now, and I’ve even told a few others, though I don’t think I’ve ever told anyone the true intensity.
I’ve started to hint at it with my therapist. His website says he uses both psychodynamic and cognitive models. I asked him which school of thought he most closely aligned with and he said cognitive. So I’m not sure how he’d react to the transference.
My attachment to him actually isn’t quite that strong yet. But I know if we continue to work together that it will be, because I’ve experienced it with others in the past.

I’m considering printing out this article, highlighting the most relevant parts, bringing it to my next session, handing it to him, and having him read it while I hide behind my chair in shame. Maybe putting a post it note on it that says if he doesn’t want to continue working with me I understand.

I haven’t checked this blog for a while, but reading through the comments today is so very helpful. So many of the comments resonate with me. TLC, your story has always felt so similar to mine in some ways at least even though I’m mostly a lurker on this site. If I may ask, did you ever go back to see your therapist? I’m in a similar position right now and feel that I’m in a tug-of-war with myself about going to my session next week vs not going. Although I am very reliable and responsible in my life outside of therapy, in therapy I’m a bit of a crazy person. I’ve cancelled, then uncancelled many sessions in the past. Right now, though, I feel a tremendous urge to no show or even ghost my therapist next week. I’m almost angry about it but I don’t know why. He is very kind and nonjudgmental. It’s like I want to prove a point, but I have no idea what that point is. I know that if I no show I will feel a weird sort of satisfaction but at the same time I will also feel immensely sad. Logically, I know I should go back, but my feelings are telling me to run for the hills. I’m just not sure which voice to listen to. And so, although our situations might be different, I’m just wondering how things turned out for you and if you ended up going back to your T?

Dear Pixiecat, (4/22/18) Thanks for this comment. I often feel I am on the other end of some kind of game-like interaction where I don’t know the meaning or what is really going on. It’s hard to bring up, because it is so easy for the patient simply to deny that anything was going on or give an excuse, but the real value is asking the question of what it means until the answer comes clear. Jeffery

Hi Pixiecat-
I thought I had given an update, but I think it might have gotten lost in cyberspace because I don’t see it here. I did give in and end up going to see him again. In a strange way I admire the fact that you have enough inner fortitude to cancel. I am going back and forth with anger feelings, too. My feelings also completely mirror what you are saying about the feelings of satisfaction and sadness. I am also mixed with guilt about even wanting to go. I know things weren’t perfect in my childhood, but I also know many people had it much worse.
I will say that I am glad that I went back though. The last couple of times he has asked the “right” questions and would not let me change the subject or stop talking. Each time we talk about my attachment for him I feel a tiny bit more comfortable about it. It is like he is trying to make it seem less weird or bad. Some of the shame about it all is sorta…kinda… going away. I guess if I could not have a good dad in my life, a pretty great therapist is going to have to do and he is a really cool guy. So this is a bittersweet feeling- I really do not know how I will ever stop wanting to go. I think some of my anger for him…or maybe at the situation is because of my knowledge that I will not be able to “keep” him. It is like going through the childhood pain my dad caused me all over again. Yuck. I am kinda ticked at me and him and the whole process. I had no clue at all that this attachment would happen on any level, let alone such a deep level. Not sure if it is all worth these feelings- but I am in too deep now anyway.
Like you Pixiecat, I so want to ghost my therapist, man that would feel good- sort of, but not at all really. I keep struggling with how long I should keep going. I keep being concerned about “overstaying” my time in therapy. You should be done– my brain says to me, three years is enough time. But then my heart says…go TLC, go. I had been going weekly for this past year, but now am trying to just go every other week and then maybe just monthly.

I do love what JCP says (up a few posts or so). But I can tell he is probably a more relaxed, “go with life” kind of personality. I am like the opposite.

Jeffrey- Do you have any advice on how to stop the “game-like interactions”? I am so guilty of this but I have no idea why I’m doing it or what it means. I keep cancelling and then uncancelling my sessions because I have tremendous urges to leave, but then I can’t leave. Last week I traded emails with my therapist about this because I was genuinely trying to figure out why I was having these urges. We figured out that it possibly has to do with feeling a teensy but closer and then feeling a recoil reaction or need to pull away after feeling closer. Once I acknowledge that, shouldn’t it get better though? Yesterday after my session I went home and sent a long email with all the reasons I’d like to quit therapy and I have no idea why I did that. I can find a lot of reasons to quit, one of which is to stop this obsession I have with wanting to quit. I feel angry that he hasn’t helped me figure this out, but maybe no one can figure me out. I just want to be a good therapy patient, but I’m failing miserably.

TLC – I’m so glad you went back. It really feels like the right thing. I’m hoping I can get my act together too!

Pixiecat, thank you. This is really valuable. The way I think about “game-like interactions” is mainly that there is a switching back and forth between the childlike persona and an adult one. I think the best thing for treatment is for the adult to have an understanding and accepting stance towards the child and for the child part to come to carry awareness of the adult point of view. If the sharp demarcation can be reduced, then each is aware of the other’s point of view, and that brings some choice about what to do. Then we get to what I call “sliding into health” where it doesn’t feel quite to necessary to hold onto one point of view or the other. I have been thinking of a post on this, but the one I’m working on today is about time and psychotherapy. Please be a bit patient. Meanwhile I hope this is helpful. Jeffery

Your situation makes me remember my own story in my therapy, which is still not over. Maybe it helps you, maybe it does not. Let’s see.

I was struggling with the ‘when shall I go to have a session’ thing. It has always been my decision depending of course on the actual availability of my therapist. Since my therapy has been going on for about 5 years now, I pretty much figured out my games and I know what the inner child wants, she acted out many times and was refused to be provided by what she was asking for. Refused with compassion and sometimes even got her needs met. So like Jeffery wrote in his post below, I know her story and I know my adult self. But one thing remained the same. I could never decide when to go…how long not to go because that decision depended upon how my therapist feels about me which I would never really get to know. So one day I explained to her in details how much of a struggle it is for me to decide when to go and how obsessively I think about it for days and days. Than she said that maybe we have to do things different. So we agreed that I decide now in the session when I would go next and than I do not go until than. Even if I wanted to, I can not go. She would not let me. 🙂 This helped me a lot actually. I started to feel freedom from her. I dont have to think because even if I wanted to, I just can not go. :)) I do NOT know what you or anyone else should do but I DO know that its a game for two people and the more our therapists know about how we feel or how we operate, the more they can help us to deal with our own feelings. The WHYs often can not be figured out, but the WHATs can and should be figured out. Wish you all the best and do not be afraid to talk about your feelings!

Thank you so much for this. Yesterday I used it to have a conversation with my therapist and it went better than I could have hoped for. A lot happened in 50 minutes.

I wasn’t kidding in my earlier comment about hiding sitting on the floor behind my chair. I wrote a cover letter explaining that I was using this to communicate something I couldn’t even write about, let alone talk about. I then attached a printout of the first part of primer (up to countertransferance) and the last part, including the section about boundaries. I highlighted the lines that were especially important/relevant to me. Then I attached a note at the end saying that I understood if he didn’t think that he could or should continue to work with me, but that I’d really rather find out now than later. (My last request was that if he was going to tell me that he tell me in straightforward way while I was still behind my chair!).
When I brought it in at the beginning of the session he wanted me to read it out loud, but I told him the only options were that he read it while I was hiding behind my chair or me throwing it away and not talking about it.
After, we had a good talk (while I was still sitting on the floor hiding). He was non judgemental and said “well if your question is if I’m still willing to work with you, the answer is yes.” I asked if he was sure, and he said yes.
When I asked he reassured me that he didn’t think I was pathetic or disgusting and that this hadn’t “freaked him out” (as I put it). I told him I hadn’t wanted to see the dawning realization and horror on his face and he told me it wasn’t that, it was compassion (I joked “that’s even worse”).
Part of my note had included that the attachment wasn’t super strong now, but that based on past patterns it would become a lot more intense if we continued to work together. He said he hoped it would be something we could talk about as it came up and that I would be willing to tell him about it. He also thanked me for sharing this with him when it was clearly difficult.
We were able to discuss that I’m often very aware of the fact that I’m reacting in completely different ways emotionally and rationally, and I now feel like I’ll be more able to share my “irrational” emotional reactions to things that I usually don’t express due to shame for feeling that way knowing full well that it’s irrational.

The primer also allowed me to highlight the importance of boundaries and we were able to talk about that. Strong boundaries are really important for me. I’ve always been the one people make exceptions for, including my last therapist who, with good intentions, became way too close. When I explained those interactions and others with other “authority figures,” my therapist assured me that what they did wasn’t right and that they should have been responsible for maintaining those boundaries. I told him that it always made me feel “special” at the time but that it felt like a responsibility and a burden and I was always having to wonder where the new shifting boundaries were and feeling responsible for not inadvertently crossing them. He promised me that he would maintain consistent boundaries and it didn’t have to be my job and that I could feel safe. That really really meant a lot.
I compared it to rock climbing when you get up to the top of the wall, the entire time having been responsible for not falling and holding on and working really hard, and then your belayer says “okay, now let go” and you have to trust that you’re no longer responsible for holding on to the wall and that your belayer will take care of it and not let you fall.

My shame is not magically gone, and I’m sure it’s not going to be easy to talk about and there will be bumps in the road, but this was my last big shameful secret and it’s out there now and my therapist is very understanding and not freaked out by it and I feel like I can trust him and that letting go of the wall is safe with him.
I even let my “inner child” ask “Are you mad at me? Do you hate me?” and he reassured me that neither of those were the case. He thanked me for trusting him with this.
He asked if I’d sit in my chair and look at him next week, and I said yes. And I was even able to look at him and make brief eye contact when I left.

Judith,
That is a super smart solution. At first I thought it would be better if our therapists just told us in the session when we had to come in next, but after thinking it through that would be treating us more like their child. This would probably cause us to act even more that way. I am not sure. I am not really sure if I am supposed to “embrace” this inner child or try to get her to hit the road. Or even more confusing for me…am I supposed to encourage the inner child? If I encourage her, will she ever want to leave?
I also like your last line about talking about your feelings. I am terrible about that, the talking part. Nearly always, I would really just prefer to write out my feelings and I do… and then I send them to my T. but he never responds back in writing. Of course that bugs me, but I will NEVER EVER tell him that– not even in writing. So all the way to the appointment I feel sick to my stomach because I actually wrote what I am feeling and thinking. Blah…my stomach just flipped because I just wrote another long one yesterday and sent it and I have an appointment this Thursday and will probably have to face what I wrote. Maybe I will get hit by a bus before then… (kidding).
He does address the emails in the sessions with me, but it still feels SO incredible uncomfortable. I am so embarrassed by my honesty– but for some reason I cannot stop myself from writing them and sending them. For me the emails are kind of like the drunk phone calls/texts people make to their ex boyfriends– they feel so stupid the next day and wish they had controlled themselves better. Can you share too much about what you are thinking and how you are feeling? Should some things actually be better left “unshared”– even with your therapist? Is there a point where you are just looking for attention? Maybe if I stopped writing the emails, stopped going to therapy, stopped overthinking it all, I could move on. Sorry if I am constantly oversharing here– this was supposed to be a little tiny response thanking Judith. In “real” life I am so different-I come off very independent and responsible. I act like I need no one.

I have been there! It is so good to read your posts, keep them coming, we can all learn, heal just by knowing there are other people out there struggling with the same issue.

I wrote emails too. The answers were always short and lacking any emotion. The only emotional text message I got was when my dog was put down and I was totally ruined. I never really put out my strong emotions to her, not even in emails because just like you I am very independent in real life. I referred to my emotions towards her in sessions, but I think she never realized it was so bad. Especially that I figured out after all the years that she must have a pattern or kind of a personality who has trouble with intimacy, so she would never fully understand someone like me who is dying for total intimacy.

This strikes me now how much of a contrast it is that I am, just like you, so dependent in therapy and come across so independent in life. I have a new job now and it is quite difficult for me to deal with my own reactions to people who dont love me straight away like crazy or who are a little more distant. I cant help but think they dont like me. Like the whole world was revolving around me. LOL.

Regarding the inner child. My advice is: be good to her or him and notice, just notice when you try to chase her away or embrace. Try different things with the inner child and see which one feels okay for you. Never judge it in any ways. After all for a small child a world is a place to discover and they dont know good or bad. Children just live. They are alive. The inner child is the same, it is alive. It does not need to be told anything, just let it be and try to feel it. Thats all. You dont have to do anything with it. After all the inner child is part of you. I really believe we all know what is good for us and nothing needs to be learned or done, we just need to let BE. There is so much pressure on us from the outer world, lets not make it even heavier for ourselves. Compassion. 🙂

I must share a funny thing. For 5 years I have been checking about 5 times a day or even more when my therapist was online the last time on fb. We are friends on fb. Now that we have this agreement that I cant just go whenever I want but only when we agreed on, I dont check at all. I became free. Boundaries! My goodness. This is so important! 🙂 Im like a 5 year old, its funny. A 5 year old 41 year old. You know she might even read this….I dont think she does but I did send her the link a year ago to have a look. :))) I dont care. I trust her now and I know that we are all good. You know it is very painful that I think these feelings of insecurity will never go away, but I still I feel like a different person and I have so much to thank to her and to myself to do the work. 🙂 I can only encourage you TLC and everyone else to keep doing it even if its hard. It really worth it!

Dont be afraid of oversharing, that is why we are here. Im checking the forum every day.
Take care!

Thanks so much for your response. I’m sorry I don’t check this site more often so I didn’t see it till now. I think the solution you and your therapist came up with is great. I have scheduled weekly appointments at the same time and day every week which makes things easier in a way because it’s one less thing I need to figure out. I actually have to pay if I don’t cancel 2 weeks in advance which at first I didn’t like, but now I’m totally fine with. Kind of takes the pressure off in a weird way.

TLC,
You are so funny with the whole drunk dialing analogy. I do the EXACT same thing with my therapist but would never do it with anyone else. I’m actually much more open and able to be vulnerable in writing, so I like it better, although if I send an impulsive email I often feel ill afterwards. I don’t seem to learn from this mistake. We just had a conversation last week about the possibility of ending therapy (at my request). I thought it went well and emailed him the next day saying I’d like to continue. I said some personal things including that I felt a connection to him and he responded with “I’ll see you next week.” I sort of feel like I’ve been punched in the gut. He technically didn’t do anything wrong but but after I opened up a bit in my email, his response felt dismissive and it kind of makes me just want to withdraw. I mean, his whole job is to be a communicator, right? You’d think he could have added another line or two acknowledging my email. Judith, it sounds like your therapist doesn’t express much via email either. Is that a thing? Why do they do that? I understand that they don’t want to conduct therapy via email. I get that. It just seems a bit harsh. It sort of seems like they are guilty of the “game-like interactions” that Jefferey refers too. I’m on the verge of sending one of those impulsive emails that I will likely regret. Hoping I can restrain myself!

Thank you so much for this primer, and all of your blog posts. I have a question about this:

“When fulfillment of age appropriate needs is steadily being transferred to the outside world, the patient will increasingly find outsiders more interesting and rewarding, and the beloved therapist, a bit boring. Then it is time to move towards reducing or ending regular sessions.”

What if termination is not precipitated by the patient’s success with the process, but by the therapist? My therapist has decided to switch careers and is closing his practice. I have been working with him for 4 years, and just recently got to the point where I was able to allow my unmet needs to surface, and begin to process the grief. I feel completely derailed – all I can focus on is the grief of loss and abandonment. So I didn’t get a chance to do the work that would allow me to detach from my therapist. He wants to do a month or two of sessions to help me process the ending, but my first couple of sessions just consisted of me alternating between rage and crying, and I was unable to speak. I don’t feel like anything is really getting “processed,” and I’m worried that I’m going to become even more dependent on him by doing this. Do you think that the termination process holds any possibility for healing in this case, or do I just need to end it now?

Hi. I stayed away from electronics for a while, now I have read the posts again, and I have something to ask. Sometimes, I feel very excited by little things in the world: planting some seeds, or the praying mantises in my garden. I feel I can hardly contain myself and I want to share, with a little-kid-like enthusiasm and even feeling, with my husband and 17-year-old son about these little things. I don’t always feel this way; I don’t always feel a need to try to relate to others about my excitements.

Today, my husband told me that sharing in this way is intrusive to him and sometimes my son, that he feels I am becoming ill, and that he will give me rules about when and where I can approach talking to him about these things.

I asked him if he wanted me to save up these things I want to share for the times when I go to therapy. He said, “well, they only have to deal with you an hour or two a week”. I feel like attachment to a therapist, at least for me, is larger than just my feelings for the therapist. It seems that I can interact with my therapist, who will listen and engage in conversation with me and sometimes share something of himself, in a way that my husband and to a lesser extent my son, is either not capable of, or there is something wrong with me. If I spend time talking and interacting with my therapist, I begin to feel close to him and come to enjoy and look forward to the time. Then I feel like I want to relate to my husband and son in a similar way, but I’m told it’s my mental illness (bipolar, apparently) getting worse.

This.is.very.frustrating.

I can’t hug my therapist and be close because, well, it’s therapy. But I don’t feel close to my husband because, well, he won’t talk to me about the things I feel excited about in the way I feel excited (little-kid-like).

It seems like a conundrum. I’m just wondering if anyone else who is in a relationship, finds that you have difficulties feeling close to your spouse and end up feeling closer, and frustrated, by feeling close to your therapist in a way that can never actually be expressed, through a hug. And what is wrong with me, and what are the rules about how you can interact with people? When I feel excited and kid-like about things, what is a better way to handle it??? Or is my husband also having problems if he can’t engage with me in this way?

i think that is the healthy side of your inner child, not something ‘wrong with you’ 😉
i can relate.. you also touch back on the idea of how can we separate ourselves in our relationship to our therapist, when our adult self forms a genuine friendship with that person as well.. much of what i’d always thought of as unmet inner child needs i now see as the normal adult social & emotional needs of someone who is INFJ (meyer/briggs) i also have a husband & grown son who i love & appreciate very much, but cannot relate to them on the same level as with my female therapist, who is a peer and had the knowledge & curiosity to try to fathom me..
please dr smith add your thoughts, if any, on this..

Hi everyone, I follow this site all the time but I havnt posted for months because it feels like a kind of betrayal of my therapist. But I feel so much of what everyone here expresses that I want to share some of my own experience. I am in my 3rd year of therapy , I now see her 4 x week so have practically moved in and still feel total loss when I leave and at weekends or longer breaks. Last month I was working 10000 miles away for 3 weeks and it was like hell. I am like 2 dissociated persons, my professional and independent persona and my 3 year old abandoned and grieving child self. Like someone else mentioned, my therapist doesn’t really talk about transference, but she knows and we talk a lot about my complete attachment and love for her. Recently I was able to say how much I long for her to physically hold me and take the pain away, she won’t do that and the grief is huge. I know she can’t repair the past but the intense need to be physically held in the present is often overwhelming. It disables me feeling like this, I often think I can’t go on with a life where my therapist is pretty much at the forefront of everything. But I can’t live without her either. I also send her emails between sessions, she always replies but often just to say yes, see you soon although she does often acknowledge how I am feeling. She never contacts me without me initiating it although I long for her to. Bottom line is I want her to be my mother, sister, friend all in one and she never will be. Yet I can’t let go and the idea of ending therapy would be torture. By the way in the Uk there is no insurance for psychotherapy, I pay my own way and if I miss sessions I pay, if she cancels or goes on her break there is no charge. I go above and beyond so I don’t miss sessions and she has never cancelled me. My fear is that my endless neediness exhausts her and she will one day abandon me, although she says she doesn’t plan to. Whatever my deep psychological issues are, she feels so wonderfully safe to be with and the critical thing is that we talk about it all, there is complete truth between us. There is no game playing, there is dynamic interaction, there is pain, terror but also warmth and humour. It feels like I am learning attachment for the first time and therefore I have to learn to separate and accept loss too. It is so hard, but I have to trust that one day I will wake up and feel healed. Therapy is such a rich gift, I only wish I had started 20 years ago.

I keep being more and more honest with my therapist about my feelings, both in my “drunk dialing emails” (haha, and ain’t it the truth though) and in real life. Thanks to you guys- Pixie and Judith for encouraging me to just be honest about the angst I felt about that next appointment. I also shared with him recently that I am so overwhelmed yet still, about feeling like I should be “done” with therapy. I expressed that he needed to just flat out tell me if I needed to be done. I don’t really want to be a “game player”as Dr. Jeffery calls it. I didn’t ever mean to be, it is just that the truth about my needs and feeling are not something I am very good at, yet. I am getting better about it though. My therapist told me to just not worry about when therapy should end– he just flat out said, “You are not done yet.” It somehow just makes me feel better to know that I can take that worry off my list– at least for now.
Pixie– I already sent my crazy email to my therapist yesterday after things kind of blew up in my extended family. This weekend and some of my siblings started shared their feelings about how they were parented. This conversation was the result of hearing that one of my older brother’s grown sons (with children of his own) accusing my brother of abuse– not so much physical(although it would be considered that in today’s world), but definitely emotional. The sad part is that though we agree that there was the abuse from our brother, we also watch this son who accused his dad do the same kinds of things to his own children. The lasting impact of how a man raises his children can have a devastating impact on far future generations. This son and his wife have decided to completely leave our family– it breaks my heart.
While each of us were sharing little things, we found that while our stories are unique in someway, they all lead to the fact that a father who is there, but not really there, is so crushing. A father who is completely unpredictable in emotion and presence is also crushing. The common thread was that we did not feel loved and our common feeling was fear. Each of us had been keeping our stories hidden– grieving our childhoods and also grieving how our childhoods caused us to parent our own children, in a screwed up way sometimes. Although all of us saw our issues, it is hard to know you are doing things wrong, when that is all you ever saw. We ended by talking about how it could ever happen that we could stop the impact a crummy parent can have for generations. Unfortunately our dad most likely, from what we can gather now, had a dad who was violent with him and then died when my dad was around 10.

I ended my email by asking my therapist specifics about how often I should really be coming in to see him now. I was also brave enough, in light of this messy and pain-filled weekend, to ask him if I could have special arrangements to see him sooner than my appointment called for. It sounds very needy and I hate myself for it, but then again maybe it is part of what I need to do.

Pixiecat– although my therapist rarely emails me back more than a few words– even in my most revealing emails, he always discusses them the next session. I think there may be like ferpa rules or something that says they really can’t communicate back with your via email. But, that being said he will not let me “wiggle out of” hiding behind the written word– he asks me to read what I have written or he reads things aloud to me. Hearing the words makes things seem more real for some reason. Sometimes I like to hide behind the written word, because it is easier for me to process things that way. But somehow he knows that if I only write it, it is not enough for me to truly accept it or get it or change it. I think this might be normal.

I suck at restraining myself from sending emails and since my therapist actually thanks me for writing I intend to keep sending them. It is something I started doing about a year ago. For 2 years it never even occurred to me to do so. I still always apologize though. He says it helps him understand what is going on in my brain better. Sometimes when I get in session, I am so overwhelmed with emotions that I can skip and jump around so much, that even I can lose my line of thinking.
Judith your story about you being a 5 year old, 41 year old completely struck a chord with this 6 year old, 45 year old. LOL. I am trying to let my inner child live in peace. It is hard after beating her down for so, very many years. But what you are saying makes sense.

Hi everyone I wonder if anyone has any suggestions for me.
I am feeling really distraught about my last few sessions with my therapist. Yesterday was so horrendous that if I let myself think about it too much I will harm myself. I already for some reason decided and visualised what I want to do !!! I know it’s awful but sometimes the pain gets so overwhelming that I need to replace it!
Please let me tell you what’s happened so ever time I see my therapist I feel like a 4 year old, and have realised its all the years of neglect from my mum that is troubling me. I seem to be looking at my therapist as a motherly figure and few months ago she offered to hold my hand when I would get so stressed that I would freeze and could not move, from then on it was a regular thing that I asked for during the last 5-10 mins of the session. At first I found it really scary and embarrass to ask if she could hold my hand but she kept assuring me that it was fine and she would never say no. Then one day she held my hand and gently stocked it, caressed it so lovingly it made me feel so amazing. It was as if my whole world had changed, the sense of love and care that encompassed me was really overwhelming and she would comment on how soft ,y hands were. Obviously with this level of intense feeling it was something I started to yearn for, it was like a drug as soon as she held my hand nothing and no one could harm me! Then for no reason one day she went from gentle caress to a strong hand grip. I was puzzled but said nothing. I find talking really difficult and most of the times I can’t even look at her. I tend to send emails to her explaining how sessions have gone. A week ago she was holding my hand then all of a sudden placed it back on my knee and started talking about finding a replacement for my need to hold her !! I was so shocked by this sudden change of heart so hurt and couldn’t understand what had I done wrong? Yesterday I had another session and she decided to reAd out my email as I had written on it how all this was making me feel and by now my head is practically placed on my knees coz the pain of what she was saying was unbearable! She said that we should find an alternative that holding ,y hand was stopping her from doing her job being a therapist and that I had to be weaned off this !
I can’t believe what had just happened how callous and heartless she is being! Considering she said she would never say No well this is definitely a kick in the teeth!
The more I think about it the more I feel she stepped over the boundaries by caressing my hand by giving me that level of comfort that made me need her more
And to say I needed to be weaned off like I as an addict or that it had happened without consent is making me feel so upset cant stop crying feeling as if I am being blamed for something she started for something she too was ok about and allowed it to happen for it now to be abruptly taken away from me is so heartbreaking don’t know what to do
Surely this cannot be my fault after all she is the professional she is th one who knows better !
So so upset feel I can’t trust her, I can’t believe what she says anymore

Don’t know what to do , but I feel she needs to be honest about her part in this process that she set up!

Dear Farah, Look at my reply to Melanie from April 4, 2018 on this post, about getting real with your therapist and facing the issue with her. Inner children want to solve things by doing something, not talking about it, but talking and exchanging emotion is really good for problems that may not have a solution. JS

Hi Farah
This is such a difficult and painful time for you. When I started reading what had happened at first I felt a twinge of envy, I want my therapist to hold me and caress me in my 3 year old state. But she and I know that isn’t going to happen however much I long for it because of exactly what has happened to you. If she crossed her boundary and held me I could never let go, I would want more and more in the belief that it will soothe and heal. But as Jeffery says that’s the inner child’s view, the adult has to learn to face pain and accept and it is through talking and feeling the compassion of your therapist that this will heal. Please talk to her about your feelings, no doubt she knows already and will help you through this rage which is also really important. Hurting yourself won’t take the pain away but eventually being heard through compassionate therapy the pain subsides.
Take care.

Hi Chimp and Farrah, I am going through this realization right now, too. All my life I have wanted someone, usually in the “safe” form of a therapist, to hold me/touch me/re-do my past. The therapist I finally have now is not perfect but he has really good boundaries and also has put up with the shenanigans I go through due to my voices. I’m not sure how to begin talking about my actual feelings, because “I don’t know how to safely feel them”. The sense of annihilation and abandonment makes it hard to be present to. I’m in my mind about it so much. Echo has written about the importance of being present to the body’s experience. I’m trying to do this and I dissociate so easily, and then beat myself up for doing so :-/

Being present to my therapist is painful. Some things I cannot talk about. He told me I don’t have to tell him, and that was a relief. I have been able to make some emotional progress since I am not struggling to say in words what I cannot without triggering the “You have to provide me with physical support” sequence of experience. Now, since I don’t feel I have to verbalize things, I’m able to relate better in words about other things in my life. Since I’m not expecting him to be there, and not trying to force him to, funnily enough I’m able to relate to him about the present without dragging the results of past into it in words. I just be how I am without having to tell him what happened. I always thought you were supposed to tell someone your trauma to heal, but it’s really a relief to know that he accepts me without telling him “why”. I’m now starting to be able to actually feel and talk about my feelings of actual shame, and the others.

Thanks Jeffrey for your response to my comment about this struggle for physical reassurance of my therapists presence. I do see the results of the mismatch. I haven’t figured out how to talk about abandonment and annihilation without it, but I’m noticing the feelings in myself and being able to withstand them for longer periods without dissociating. Breathing and affirmations seem to help, as well as noticing when I’m beating up on myself about it. I still take psychiatric medications but I’m learning what they do for me and how to manage them better. It’s scary but I am doing better. I am still struggling with how or if to experience the feelings of dissociation, abandonment, and the threat of annihilation while I’m at therapy. I hope that if I do then these episodes will be reduced, but I wish there was a guarantee it would work. It feels very risky. Very, very risky.

I am so sorry to hear what has happened? Any news since than? Did you talk about it with her? How do you feel now?

Some of you have read my story of not setting the new appointment and not being able to change it. Now the 2 months break in my therapy was over and I had a session again. I had a kind of a feeling like what am I doing here? I feel it because I know that the only reason I go there is to get her to my friend, my mother whatever and I don’t want to admit that it will never happen and I just have no more reason to go.
She said something which hurt me a lot. I could not feel it or say it there but I froze. She asked me how I felt about this break and I told her it felt good and I felt OK. All good but than she used a word which hit me like someone punched me in the face. She said that what we do now….the fact that Im going there every 2 months is FOLLOW UP. You understand what it means? It means for her my therapy is OVER. And this is follow up. It hurts me now. I thought Im still in therapy….but she considers it that to be over? Than after the shock I said to myself: I don’t care, its me who decides if its over or not, after all she is following the ideas of Carl Rogers….so its the client who knows what is really going on…:) Anyway….now I feel like whatever she says or thinks what eventually matters is what I feel and think and I really felt like without her I am free (if I manage not to think of her and have some freedom) and once I see her my life just becomes this obsession. So the solution seems like to get myself out of therapy and somehow try to admit its really over. I think I know its over but Im not ready to admit? I don’t know, Im confused, sad. At the same time I experiencing a distance from my family, too. I don’t see them often and by being alone a lot I sometimes feel all the sadness I used to feel when I was a child and felt so alone in this world and unloved. I so long for a normal relationship, too. A husband or a boyfriend at least. Im 41 for God’s sake, what is going on? At this moment I really feel lonely and could just run away to another world.